Group-Based Behavioral Weight Loss Intervention Successful in Overweight/Obese Breast Cancer Survivors
Obesity increases the risk for overall and breast cancer mortality and comorbidity. As reported in the Journal of Clinical Oncology by Rock et al, the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study has shown that a group-based behavioral intervention can produce sustained weight loss in overweight/obese breast cancer survivors.
Study Details
In this trial, the largest weight loss intervention trial in breast cancer survivors reported to date, 692 women at an average of 2 years since treatment for early-stage disease were randomized to a group-based behavioral intervention supplemented with telephone counseling and tailored newsletters (n = 344) or a less-intensive control intervention (n = 348) and observed for 2 years.
The group-based intervention consisted of a 4-month phase of weekly 1-hour group sessions for an average of 15 women, followed by sessions every other week for 2 months, and monthly during the remainder of the first year. Sessions focused on energy intake and exercise. Personalized guidance was provided by telephone or e-mail. Tailored newsletters were provided quarterly from 6 to 24 months. The control group was provided weight-management resources and materials in the public domain. An individualized diet counseling session was provided at baseline and 6 months, and participants received monthly telephone calls or e-mails and were invited to attend seminars on aspects of healthy living other than weight control every other month during the first year.
Weight Loss
Mean weight loss was 6.0% in the intervention group vs 1.5% in the control group at 12 months (P < .001) and 3.7% vs 1.3% at 24 months (P < .001). At 12 months, 55% of the intervention group had lost ≥ 5% of their initial weight and 26% had lost ≥10%; at 24 months, these rates were 44% and 15%. At 24 months, in the intervention group, mean weight loss was 0% in women younger than age 45, 2.1% in those aged 45 to 54 years, and 5.2% in those aged ≥ 55 years (P < .001).
Systolic and diastolic blood pressure was lower (P ≤ .05) in the intervention group at 6, 12, 18, and 24 months, except for diastolic pressure at 12 months. A greater proportion of the intervention group reported moderate/strenuous physical activity at 6 and 12 months, but physical activity level was similar in the two groups at 18 and 24 months.
The investigators concluded, “A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival.”
Cheryl L. Rock, PhD, RD, of the University of California, San Diego, Moores Cancer Center, is the corresponding author of the Journal of Clinical Oncology article.
The study was supported by the National Cancer Institute and the National Institutes of Health.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
