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Randomized Controlled Trial
. 2015 Oct 1;33(28):3169-76.
doi: 10.1200/JCO.2015.61.1095. Epub 2015 Aug 17.

Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors

Cheryl L Rock  1 , Shirley W Flatt  2 , Tim E Byers  2 , Graham A Colditz  2 , Wendy Demark-Wahnefried  2 , Patricia A Ganz  2 , Kathleen Y Wolin  2 , Anthony Elias  2 , Helen Krontiras  2 , Jingxia Liu  2 , Michael Naughton  2 , Bilgé Pakiz  2 , Barbara A Parker  2 , Rebecca L Sedjo  2 , Holly Wyatt  2
Affiliations
Randomized Controlled Trial

Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors

Cheryl L Rock et al. J Clin Oncol. .

Abstract

Purpose: Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is the largest weight loss intervention trial among survivors of breast cancer to date.

Methods: In this multicenter trial, 692 overweight/obese women who were, on average, 2 years since primary treatment for early-stage breast cancer were randomly assigned to either a group-based behavioral intervention, supplemented with telephone counseling and tailored newsletters, to support weight loss or a less intensive control intervention and observed for 2 years. Weight and blood pressure were measured at 6, 12, 18, and 24 months. Longitudinal mixed models were used to analyze change over time.

Results: At 12 months, mean weight loss was 6.0% of initial weight in the intervention group and 1.5% in the control group (P<.001). At 24 months, mean weight loss in the intervention and control groups was 3.7% and 1.3%, respectively (P<.001). Favorable effects of the intervention on physical activity and blood pressure were observed. The weight loss intervention was more effective among women older than 55 years than among younger women.

Conclusion: A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival.

Trial registration: ClinicalTrials.gov NCT01112839.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org. Author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Participant flow during enrollment, exclusions during screening, and clinic visit participation.
Fig 2.
Fig 2.
Proportion of study participants achieving a weight loss of more than 5% and more than 10% of initial weight at 12 and 24 months.
See this image and copyright information in PMC

Comment in

  • Reply to W. Hryniuk et al.
    Rock CL, Demark-Wahnefried W, Byers TE, Colditz GA, Liu J, Pakiz B, Sedjo RL, Ganz PA. Rock CL, et al. J Clin Oncol. 2016 Apr 1;34(10):1153. doi: 10.1200/JCO.2015.65.7049. Epub 2016 Jan 25. J Clin Oncol. 2016. PMID: 26811516 No abstract available.
  • Psychiatric Disorders Impeding Weight Loss in Obese Breast Cancer Survivors.
    Hryniuk W, Jenkins I, Djuric Z. Hryniuk W, et al. J Clin Oncol. 2016 Apr 1;34(10):1152-3. doi: 10.1200/JCO.2015.65.5639. Epub 2016 Jan 25. J Clin Oncol. 2016. PMID: 26811517 No abstract available.

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