Wendy Demark-Wahnefried, PhD, RD, Professor and Webb Endowed Chair of Nutrition Sciences at the University of Alabama at Birmingham, formal discussant for the SHAPE-2 and LEAN trials at the ASCO Annual Meeting, emphasized the importance of weight loss, but noted that it can be challenging for patients.

“There is a consensus that women with increased body mass index are at increased risk. Guidelines suggest that diet, exercise, and behavior modification are all necessary. But it is easy and simplistic to say exercise will make you lose weight. It takes a lot of exercise to burn off a few calories. For example, it takes 6 minutes of chopping wood to work off six jelly beans. Achieving exercise goals is somewhat easier than cutting calories, but eating less is key to weight loss.”

Implications for Survivors

Dr. Demark-Wahnefried highlighted the importance of addressing weight loss with breast cancer survivors, as reflected by results of the LEAN study.

“I want to pay attention to results in the control group who lost 2% of body weight in this study. We would expect people with no intervention to gain weight. This is a victory for a pamphlet,” she said.

“It is interesting that in-person and telephone counseling appear to have equivocal effects on weight loss. These results should encourage you to address weight loss with breast cancer survivors. Tell them, ‘I’m counting on you to improve your well-being. Here is your body mass index and it could affect your outcome. You should exercise and think about what you eat,’” she said.

One of ASCO’s current public health initiatives is targeting weight loss, she continued, and a tool kit for this purpose has been developed. ■

Disclosure: Dr. Demark-Wahnefried reported no potential conflicts of interest.