Behavioral weight loss intervention effectiveness in gynecologic oncology clinics is minimal; nearly half of obese endometrial cancer survivors gain weight over 12 months

Background: Serum lipopolysaccharide-binding protein (LBP), a surrogate biomarker for gut barrier permeability, is higher in adults with obesity and type 2 diabetes and may trigger inflammation. It is unknown whether a behavioral weight loss intervention or metformin — current first-line treatments for obesity or diabetes — can reduce gut permeability. Objective: To determine the effects of behavioral weight loss intervention or metformin, compared to self-directed weight loss, on serum LBP. Methods: SPIRIT was a parallel-arm, randomized trial of adult cancer survivors with overweight or obesity. Participants were randomized to a self-directed weight loss (control), metformin, or coach-directed (healthy diet/physical activity) weight loss arm. Of 121 randomized participants, a random subset (n=88) had LBP measured at baseline, 6-months, and 12-months post intervention. The effects of interventions on LBP over time were assessed using generalized estimating equations (GEE). Models were further adjusted for absolute change in fiber intake to investigate potential mediation. Results: Arms were balanced by sex (83% female), race (48% black), and age (mean 60 years). There were no between-group differences in LBP at baseline (median 42.3 μg/dL). Over the 12-month period, only the coach-directed and metformin arms showed weight loss (both mean -3% from baseline). Similar increases in LBP were seen in the self-directed and metformin arms, while a decrease in LBP was seen in the coach-directed arm ( figure ). In GEE models, the difference in slopes between the coach vs. self-directed arms was statistically significant (β=-1.67, p=0.037), but not between the metformin and self-directed arms (β=0.003, p=0.997). The effect of coach-directed weight loss on LBP was similar by sex and race and was not mediated by changes in fiber intake. Conclusion: The manner of weight loss can differentially impact gut permeability and thus subsequent exposure to proinflammatory microbial products.

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Effectiveness of an Internet Delivered Behavioral Weight Loss Intervention Provided to Breast Cancer Survivors

Advances in Obesity Weight Management & Control ◽

10.15406/aowmc.2015.02.00021 ◽

2015 ◽

Vol 2 (3) ◽

Cited By ~ 1

Author(s):

Kim Dittus L

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Impact of a behavioral weight loss intervention on comorbidities in overweight and obese breast cancer survivors

Supportive Care in Cancer ◽

10.1007/s00520-016-3141-2 ◽

2016 ◽

Vol 24 (8) ◽

pp. 3285-3293 ◽

Cited By ~ 2

Author(s):

Rebecca L. Sedjo ◽

Shirley W. Flatt ◽

Tim Byers ◽

Graham A. Colditz ◽

Wendy Demark-Wahnefried ◽

...

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Changes in Dietary Intake After Metformin Treatment and Behavioral Weight Loss Intervention in Overweight or Obese Cancer Survivors: Results from a Randomized Clinical Trial (P05-029-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz030.p05-029-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Zhongyu Li ◽

Noel Mueller ◽

Juraschek Stephen ◽

Hsin-Chieh Yeh ◽

Lawrence Appel ◽

...

Keyword(s):

Weight Loss ◽

Cancer Survivors ◽

Dietary Fiber ◽

Food Consumption ◽

Metformin Treatment ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Directed Group ◽

Behavioral Weight Loss Intervention ◽

Risk Of Cancer

Abstract Objectives Metformin and behavioral weight loss are postulated to lower the risk of cancer development and recurrence in overweight/obese individuals. Few studies have compared dietary changes longitudinally associated with these interventions. This study aimed to investigate the effects of metformin treatment and coach-directed behavioral weight loss intervention on overweight/obese cancer survivors’ food consumption, with an emphasis on fruits, vegetables, fiber, and fat intakes. Methods Overweight and obese cancer survivors enrolled in the SPIRIT trial (n = 121) were randomized into three arms consisting of self-directed weight loss (control), coach-directed weight loss and metformin treatment. Fruit, vegetable and fat screeners were used to assess the diet of the participants at baseline, 3-month, 6-month, and 12-month visit. Linear regression models and Generalized Estimated Equations were performed in STATA 15.1 to analyze the associations between interventions and food consumption throughout the study. Results Groups did not differ by sex (79% female), race (45% black) or age (mean 60 years). Metformin treatment was associated with decreased dietary fiber intake versus self-directed group (difference in slope β = −0.13, 95%CI: −0.01, −0.25; P = 0.04) and versus coach-directed group (−0.130, 95%CI: −0.02, −0.24; P = 0.02). After adjusting for baseline intake, participants assigned to metformin treatment consumed less dietary fiber daily than did participants in the self-directed (−2.0 grams, 95%CI: −0.47, −3.53; P = 0.01) and coach directed groups (−1.54 grams, 95%CI: −0.12, −2.95; P = 0.03) at the 12-month visit. Fruit and vegetable servings also decreased among participants in the metformin group versus non-metformin groups (difference at 12 months = −0.47 servings, 95%CI: 0.00, −0.94; P = 0.05). Coach-directed weight loss reduced % calories from fat compared to self-directed (−1.5% P = 0.03). Conclusions Metformin treatment in overweight/obese cancer survivors was associated with reduced intake of fruits, vegetables, and dietary fiber. The unintended and negative changes of diet that could result in negative impacts on health in metformin users should be noticed in clinical practices and deserve further research. Funding Sources Maryland Cigarette Restitution Funds and SKCCC. Supporting Tables, Images and/or Graphs

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Psychological and behavioral pathways between perceived stress and weight change in a behavioral weight loss intervention

Journal of Behavioral Medicine ◽

10.1007/s10865-021-00231-z ◽

2021 ◽

Author(s):

Kristine Molina ◽

Monica L. Baskin ◽

Dustin Long ◽

Tiffany L. Carson

Keyword(s):

Weight Loss ◽

Perceived Stress ◽

Weight Change ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Abstract P249: A Behavioral Weight Loss Intervention is Effective for Change in CVD Risk Factors in Young Adults: The IDEA Study

Circulation ◽

10.1161/circ.131.suppl_1.p249 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

John M Jakicic ◽

Kelliann K Davis ◽

Bethany Barone Gibbs ◽

Diane Helsel ◽

Wendy C King ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Young Adults ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Introduction: Few studies have examined behavioral weight loss interventions with respect to change in cardiovascular disease risk factors in young adults (aged 18 to 35 years). Hypothesis: We tested the hypothesis that a 6 month behavioral weight loss intervention resulted in significant improvements in selective cardiovascular disease risk factors in young adults. Methods: Data are presented as median [25 th , 75 th percentiles]. 470 participants (age: 30.9 [27.8, 33.7] years); BMI: 31.2 [28.4, 34.3] kg/m 2 ) were enrolled in a 6 month behavioral weight loss intervention that included weekly group sessions and prescribed an energy restricted diet and moderate-to-vigorous physical activity. Assessments included weight using a standardized protocol, resting blood pressure, and fasting lipids, glucose, and insulin. Statistical significance of change was according to tests of symmetry or the Wilcoxon matched pairs signed ranks test. Results: The primary outcome (weight) was available for 424 of the 470 participants (90.2%). Weight significantly decreased (-7.8 kg [-12.2, -3.7]) (p<0.0001). Systolic (-4.0 mmHg [-8.5, 0.5] and diastolic blood pressure (-3.0 mmHg [-6.5, 1.0]) decreased (p<0.0001). Total cholesterol (-13 mg/dl [-28.0, 2.0]), LDL cholesterol (-9.5 mg/dl [-21.7, 2.0]), triglycerides (-8.5 mg/dl [-44.0, 9.0]), glucose (-4.0 mg/dl [-8.0, 1.0]), and insulin (-2.6 mIU/L [-5.9, 0.7]) decreased (p<0.0001, n=416). There was not a significant change in HDL cholesterol (p=0.72). Conclusions: In conclusion, after 6 months, weight loss was observed in young adults assigned to this behavioral intervention that focused on physical activity and diet modification. They tended to also have improved cardiovascular disease risk factors. This may demonstrate an approach to reducing cardiovascular disease risk in young adults. Supported by NIH (U01HL096770) and AHA (12BGIA9410032)

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