Perceptions of unintentional weight loss among cancer survivors.

Abstract

138 Background: Unintentional weight loss (WL) can be a disruptive symptom of cancer, yet its psychosocial impact is not well understood. We examined cancer survivors’ experiences with unintentional WL. Methods: 320 cancer survivors completed an online survey, provided demographic, health, and unintentional WL history, and rated (0 = not at all; 4 = extremely) 19 statements about WL outcomes. We examined bivariate associations between weight status, unintentional WL, and WL outcomes. Results: Participants were 90% White; mean age = 58.8 years, SD= 11; 41% breast cancer, 23% blood cancer, 8% prostate cancer, mean time since diagnosis = 6.0 years, SD= 5; 18% metastatic, 22% current recurrence/relapse, 51% remission. 55 participants (17%) reported unintentional WL in the past 6 months (mean = 16lbs; range = 2-70; mean BMI = 27.6, SD= 6.3). These participants were less likely to be in disease remission ( p< .05). Participants with unintentional WL tended to underestimate their weight category (e.g., of BMI-classified healthy weight participants, 26% believed they were underweight); κ = -.17, p< .01. 51% of participants felt (somewhat to extremely) positive about WL, 49% said their health care team was supportive of WL; these statements were more strongly endorsed by people describing themselves as overweight ( ps < .05). 27% believed WL caused physical weakness, 23% said WL resulted in lost control over nutrition/eating, 16% said WL made them feel like a burden, 14% said WL caused them to lose their identity; these statements were more strongly endorsed by people describing themselves as underweight ( ps < .01). 20% viewed their WL as a sign of approaching end of life, 13% believed WL meant they would not be able to continue treatment; these views did not differ by perceived weight status. Conclusions: Many cancer survivors experience unintentional weight loss and associate their weight loss with negative outcomes. Survivors also often underestimate their weight status, which is notable given that personal views of one’s weight status, not BMI-derived weight status, is associated with beliefs about the impact of unintentional weight loss. Our findings suggest that people believe unintentional WL meaningfully affects their quality of life.