An intervention helps women with breast cancer lose weight

An intervention helps women with breast cancer lose weight

24 Aug 2015

Weight gain after breast cancer is not uncommon, but researchers report that an intervention aimed at changing eating and exercise habits can help women lose weight and possibly keep it off.

The mean weight loss of breast cancer patients in an intervention group was significantly higher than that of a control group, according to analysis of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial.m"A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer," Cheryl L. Rock, PhD, RD of the University of California, San Diego, and colleagues wrote in their report.

Profile of the study participants

The study recruited 692 and randomized them to the intervention or a less rigorous intervention. The inclusion criteria were:

  • an age ≥ 21 years,
  • a breast cancer history (stage I [≥ 1 cm], II, or III) with
  • a diagnosis within the last 5 years, a BMI between 25 and 45 kg/m2, and
  • participation in early therapies (but not endocrine therapy).

Candidates with serious medical conditions including congestive heart failure, paralysis, and significant psychiatric illnesses were among those excluded.

Methodology of the intervention

The intervention involved:

  • obesity-specific cognitive behavioral therapy,
  • heightened physical exercise, and
  • personalized diet changes that create an energy deficit of 500-1000 kcal.

Diet and physical activity changes were self-directed and inspired by group meetings and the customized newsletters that provided helpful suggestions, such as meal planning. The control group was given standard weight loss materials available to the general public.

Height, weight, waist circumference, blood pressure, and physical activity were measured throughout the trial. Physical activity for the intervention group averaged 212 minutes per week at the 12-month follow-up, compared with 139 minutes per week for the control group.

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The results of the intervention were influenced by age and treatment history

Women in the intervention group lost 5.9% of their baseline weight at 6 months and were able to sustain a reduction of 3.7% from baseline for 2 years compared with a 1.3% loss at 6 months for controls and 1.1% at 2 years. The study was, however, powered to detect 7% reduction from baseline at 2 years, which was not achieved.

However, authors noted that physical activity levels for both groups were similar at the 18- and 24-month follow-ups, signifying a decrease for the intervention group compared to earlier in the trial.  Not all intervention subgroups succeeded equally. At the 24-month follow-up, women who never received chemotherapy lost 6.1% of their initial weight, compared with the 3% for those who did.

Age was also a significant factor in success. Women younger than 45 lost 0% of their initial weight on average at the 24-month follow-up, while women between 45 and 55 lost 2.1% and women above 55 lost 5.2%. This occurred despite the younger women equaling their elder counterparts for physical activity. Age and behavioral intervention participation were the only solid predictors for sustained weight loss at the end of the trial.

“An important step towards weight loss in breast cancer"

"Studies employing distance-based intervention that implement weight loss through telephone and web-based approaches hold the promise to provide weight loss interventions across a broad range of geographic, socioeconomic, and cultural settings," said Jennifer Ligibel, MD, director of the Leonard P. Zakim Center for Integrative Therapies at the Dana-Farber Cancer Institute. "The ENERGY study represents an important step in demonstrating the feasibility of weight loss in breast cancer patients."

One limitation the authors noted was the self-reported physical activity levels, since study participants are not often fully accurate about their exercise habits. Also, the majority white participant pool made analyzing results across race/ethnicities unfeasible. The authors theorized that participants that dropped out before the 24-month follow-up were heavier than at the 12-month follow-up, but their weights are unavailable and not reflected in the 24-month averages. However, the dropout rate was fairly low.

Source: MedPage Today

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