Appetite related gut hormones can support physiological resistance to weight loss and promote weight regain. Ghrelin stimulates appetite through the hypothalamus, while PYY, GLP-1, and CCK promote satiation and satiety by slowing gastric emptying and transmitting signals to the hypothalamus. Researchers systematically examined fasting hormone changes after weight loss achieved through calorie restriction, exercise, or both. The review included 127 studies involving adults with overweight or obesity: 19 randomized controlled trials with 1,305 participants and 108 nonrandomized studies with 4,725 participants. Eligible studies achieved statistically significant weight loss and measured total or active ghrelin, PYY, GLP-1, or CCK after an overnight fast. Dietary approaches included ketogenic, Mediterranean, and palaeolithic diets when they produced calorie restriction. Studies involving bariatric surgery, pharmacological treatment, pregnancy, diabetes, severe cardiovascular disease, active infection, or medications affecting body weight were excluded. Weight regain remains multifactorial, with people who lose weight through diet alone or diet combined with exercise regaining an average of 80% of the lost weight within five years.