The effects of a clinic-based weight loss program on health-related quality of life and weight maintenance in cancer survivors: A randomized controlled trial

Abstract

Objective: The Healthy Living and Eating After Cancer Trial demonstrated that a clinic-based weight loss program reduced body weight, as compared with a waitlist control group, over 15 weeks. Here we report the impact of the weight loss intervention on health-related quality-of-life outcomes at week 15, and maintenance of weight loss to week 30.

Methods: This trial randomized cancer survivors of solid tumors and hematologic malignancies (breast cancer: 76.7%) to a 15-week group-based weight loss program (n = 30) or a waitlist control group (n = 30). Participants were not blinded to group assignment. Participants completed a variety of health-related quality-of-life outcome measures at baseline and week 15. From week 15 to week 30, participants initially randomized to the weight loss program were followed with no additional intervention, and participants initially randomized to the waitlist control group commenced the weight loss program.

Results: Over the 15 weeks, the weight loss program improved physical functioning (6.2 ± 2.9; p = 0.02; d = 0.31) and reduced insomnia symptoms (-17.1 ± 7.4; p = 0.03; d = -0.30) as measured by the EORTC QLQ-C30, and sleep disturbance (-4.9 ± 1.6; p = 0.005; d = -0.40) as measured by PROMIS, compared to waitlist control. After a weight loss of 4.6 ± 3.9 kg, from week 15 to week 30, participants who were initially randomized to the weight loss program maintained their prior weight loss (+0.6 ± 3.5 kg) and participants who were initially randomized to the waitlist control group lost weight (-3.4 ± 2.9 kg; p < 0.001).

Conclusions: In cancer survivors with overweight or obesity, a 15-week clinic-based weight loss program improved health-related quality-of-life outcomes and produced sustained weight loss to week 30.

Trial registration: ClinicalTrials.gov NCT01978899.

Keywords: cancer; obesity; oncology; patient-reported outcome measures; psycho-oncology; quality of life; randomized controlled trial; weight loss.

Conflict of interest statement

Disclosures: The authors declare no conflicts of interest.

© 2022 John Wiley & Sons Ltd.

Figures

Figure 1.

Change from baseline in body weight in response to the Healthy Living and Eating intervention in the immediate- versus delayed-intervention arms over 30 weeks. Participants randomized to the immediate intervention commenced a 15-week group-based weight loss program; from week 15 to week 30 these participants entered long-term follow-up for weight maintenance. Participants randomized to the waitlist (delayed) control intervention consumed a usual (e.g., pre-study) diet and engaged in usual physical activity until week 15; from week 15 to week 30 these participants commenced the 15-week group-based lifestyle program. Error bars depict standard errors.