Abstract
BackgroundBreast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women.MethodsOverweight or obese (n = 243) and normal weight (n = 166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes.ResultsForty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight −2.3 (−3.5, −1.0) kg, body fat −1.6 (−2.6, −0.7) kg, community vs. control; weight −2.4 (−3.6, −1.1) kg, body fat −1.4 (−2.4, −0.5) kg (all p < 0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective.ConclusionsThe programmes were equally effective for weight control, but the community programme had additional benefits.Clinical trial registrationISRCTN68576140
Highlights
Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain
Effective for weight control, the community programme was more effective for increasing physical activity (PA), whilst the home programme appeared more effective for dietary change and reducing energy intake
The greater PA in the community group probably accounts for the greater reductions in insulin, lipids[33] and blood pressure,[34] and improvements in fitness and quality of life (QOL).[35]
Summary
Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women. A large number of trials amongst overweight or obese BC patients after diagnosis report that weight loss is feasible and safe[10,11] most of these were initiated long after completion of adjuvant treatment, and after the weight gain associated with diagnosis and treatment had occurred.[10,11] Three small randomised studies demonstrate the feasibility and reasonable compliance of weight and exercise programmes based either on clinic visits or telephone interventions during chemotherapy soon after BC diagnosis.[12,13,14].
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