This prospective interventional study investigated changes in perceived stress, serum cortisol concentrations, body weight, and body composition during a 12-week individualized energy-restricted dietary intervention in adults with overweight or obesity. Participants followed an individually prescribed Mediterranean-style energy-restricted diet and attended weekly follow-up visits throughout the intervention. Body weight and body composition were assessed at weekly follow-up visits, while perceived stress and biochemical parameters, including serum cortisol, were evaluated at baseline and at the end of the 12-week intervention. Sleep quality and physical activity were also assessed at baseline. The study further examined whether perceived stress, serum cortisol, sleep quality, and physical activity were associated with the magnitude of body weight and fat mass loss achieved during the dietary intervention.