170 Background: Endometrial cancer affects 50,000 women a year. Obesity plays a significant role in the pathogenesis of endometrial cancer. Obese endometrial cancer survivors (ECS) are at significant lifetime risk of diabetes, cardiovascular disease (CVD), recurrence and death. There are no prospective studies examining the role of diet only in attempting to achieve weight loss in obese ECS. Protein sparing modified fast (PSMF), an approach to rapid weight loss, has been used to treat obesity in a safe manner. A pilot study is underway to investigate the feasibility of a PSMF for weight loss in this high risk population. Methods: To date, seven obese (BMI > 30kg/m^2) ECS have been placed on a PSMF under the supervision of a physician and dietitian. Patients provided demographic information and Obesity Quality of Life (OQOL) questionnaire. Comprehensive metabolic panel with lipid panel and biomarkers of inflammation were drawn. Patients were instructed to eliminate carbohydrate containing foods and to augment with 1.2g/kg of protein per obesity-adjusted ideal body weight. Primary objectives are: total weight loss, subject retention, compliance, side effects, QOL and alterations in markers of obesity and inflammation. Results: The median age of the patient group was 56 years. Median baseline weight was 292.4 pounds (185.9-369). Median BMI was 44.5 kg/m2 (37.5-61.4). Mean baseline leptin level was 54.3 ng/ml (normal: 2.5-21.8). Mean baseline C-reactive protein level, a strong marker for CVD, was 4.574 (high risk for CVD > 3). At 4 weeks median percent body weight lost was -6.48% (5.19%-7.00%). At 3 months the median loss nearly doubled to -13% (8.31%-14.11%). Significant reduction in CRP and leptin occurred in 2 patients: mean decrease was 3.9 and 28 points respectively. Conclusions: Our early data demonstrate that significant weight loss in obese endometrial cancer survivors is achievable in a standard outpatient gynecologic oncology practice. While long term follow up data and elucidation of the true significance of improvement in serum inflammatory markers are needed, we do know that even a 5-10% loss of body weight can lead to substantial improvement in CVD and diabetes risk.
Obese endometrial cancer survivors’ perceptions of weight loss strategies and characteristics that may influence participation in behavioral interventions
