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Weight gain prior to entry into a weight-loss intervention study among overweight and obese breast cancer survivors

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Abstract

Purpose

Changes in cancer therapy, in addition to changes in obesity prevalence, suggest the need for a current assessment of weight gain patterns following breast cancer diagnosis. The aim of this study was to evaluate factors associated with weight gain among breast cancer survivors prior to enrolling into a behavioral weight loss intervention.

Methods

Anthropometric measures and data on weight-related factors were collected at baseline on 665 breast cancer survivors. Postdiagnosis weight gain was determined between entry into the trial and previous diagnosis up to 5 years. Multivariate logistic regression analyses were used to evaluate the association between weight gain and influencing factors.

Results

The mean weight gain was 4.5 % body weight (standard deviation = 10.6); 44 % of women experienced ≥5 % body weight gain. The risk of weight gain was inversely associated with age (adjusted odds ratio (ORadj) = 0.97, 95 % confidence interval (95 % CI) 0.95–0.99), Hispanic ethnicity (ORadj = 0.30, 95 % CI 0.13–0.68), and overweight (ORadj = 0.11, 95 % CI 0.05–0.23) or obese (ORadj = 0.03, 95 % CI 0.02–0.07) status at diagnosis and positively associated with time elapsed since diagnosis (ORadj = 1.19/year, 95 % CI 1.04–1.36). Women prescribed aromatase inhibitors were 46 % less likely to gain weight compared to women prescribed selective estrogen-receptor modulators (ORadj = 0.54, 95 % CI 0.31–0.93). The risk of weight gain was positively associated with smoking at diagnosis (ORadj = 2.69, 95 % CI 1.12–6.49) although this was attributable to women who subsequently quit smoking.

Conclusions

Postdiagnosis weight gain is common and complex and influenced by age, ethnicity, weight, smoking status, time elapsed since diagnosis, and endocrine-modulating therapy.

Implications for cancer survivors

Weight gain continues to be a concern following a diagnosis of breast cancer. Factors influencing this weight gain include age, ethnicity, weight, smoking status, time elapsed since diagnosis, and endocrine-modulating therapy. Effective weight management strategies are needed for this population of women.

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Acknowledgments

Funding for the ENERGY trial was provided by the National Cancer Institute (CA148791). This research was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) under award number UL1TR00165 at the University of Alabama at Birmingham and by the NIH/NCATS Colorado CTSI Grant Number UL1 TR001082 at the University of Colorado Denver. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views. The authors would also like to recognize the subjects for their participation and to acknowledge the ENERGY Trial Group.

The ENERGY trial group

University of California, San Diego: Cheryl Rock, PhD, RD, Bilge Pakiz, EdD, Barbara Parker, MD, Chris Zoumas, MS, RD, Shirley Flatt, MS, Hava Shoshana Barkai, MS, RD, Dennis Heath, MS, Lea Jacinto, Mila Pruitt.

University of California, Los Angeles: Patricia A. Ganz, MD.

University of Colorado Denver: Tim Byers, MD, MPH, Rebecca Sedjo, PhD, Holly Wyatt, MD, Anthony Elias, MD, Anna Van Pelt, MPH, Kim Gorman, MS, RD.

Washington University in St. Louis: Graham Colditz, MD, Kathleen Wolin, ScD, Esther Liu, PhD, Michael Naughton, MD, Casey Fagin, MA, Jennifer Tappenden, Sonya Izadi.

University of Alabama at Birmingham: Wendy Demark-Wahnefried, PhD, RD, Helen Krontiras, MD, Maria Azrad, PhD, RD, Cindy Blair, PhD, Sonthe Burge, MS, RD.

Conflict of interest

The authors (RLS, TB, PG, GC, WDW, KYW, MA, CLR) declare no disclosures of any financial or personal relationships that could pose a conflict of interest with the subject matter of this article.

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Authors and Affiliations

  1. Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver, 13001 East 17th Place, MS F519, Aurora, CO, 80045, USA

    Rebecca L. Sedjo

  2. Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, 13001 E. 17th Place, Aurora, CO, 80045, USA

    Tim Byers

  3. Jonsson Comprehensive Cancer Center, University of California, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA, 90095-6900, USA

    Patricia A. Ganz

  4. Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, Saint Louis, MO, 63110, USA

    Graham A. Colditz

  5. University of Alabama Comprehensive Cancer Center, University of Alabama at Birmingham, 1824 6th Avenue, Birmingham, AL, 35294, USA

    Wendy Demark-Wahnefried

  6. Department of Public Health Sciences, Loyola University Chicago Stritch School of Medicine, 2160 S. First Ave, Maywood, IL, 60153, USA

    Kathleen Y. Wolin

  7. Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd, 348 Webb, Birmingham, AL, 35294, USA

    Maria Azrad

  8. Department of Family and Preventive Medicine, School of Medicine, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA, 92093, USA

    Cheryl L. Rock

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  1. Rebecca L. Sedjo
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Correspondence to Rebecca L. Sedjo.

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Sedjo, R.L., Byers, T., Ganz, P.A. et al. Weight gain prior to entry into a weight-loss intervention study among overweight and obese breast cancer survivors. J Cancer Surviv 8, 410–418 (2014). https://doi.org/10.1007/s11764-014-0351-9

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  • DOI: https://doi.org/10.1007/s11764-014-0351-9

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