Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 6;12(1):e0169173.
doi: 10.1371/journal.pone.0169173. eCollection 2017.

Weight Loss and Mortality in Overweight and Obese Cancer Survivors: A Systematic Review

Sarah E Jackson  1 , Malgorzata Heinrich  1 , Rebecca J Beeken  1 , Jane Wardle  1
Affiliations

Weight Loss and Mortality in Overweight and Obese Cancer Survivors: A Systematic Review

Sarah E Jackson et al. PLoS One. .

Abstract

Background: Excess adiposity is a risk factor for poorer cancer survival, but there is uncertainty over whether losing weight reduces the risk. We conducted a critical review of the literature examining weight loss and mortality in overweight or obese cancer survivors.

Methods: We systematically searched PubMed and EMBASE for articles reporting associations between weight loss and mortality (cancer-specific or all-cause) in overweight/obese patients with obesity-related cancers. Where available, data from the same studies on non-overweight patients were compared.

Results: Five articles describing observational studies in breast cancer survivors were included. Four studies reported a positive association between weight loss and mortality in overweight/obese survivors, and the remaining study observed no significant association. Results were similar for non-overweight survivors. Quality assessment indicated high risk of bias across studies.

Conclusions: There is currently a lack of observational evidence that weight loss improves survival for overweight and obese cancer survivors. However, the potential for bias in these studies is considerable and the results likely reflect the consequences of disease-related rather than intentional weight loss. There is a need for stronger study designs, incorporating measures of intentionality of weight loss, and extended to other cancers.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of search strategy and study selection.
Fig 2
Fig 2. Assessment of studies’ risk of bias.
Fig 3
Fig 3. Forest plot of risk estimates from observational studies of weight loss and mortality outcomes in overweight and obese (BMI ≥25) breast cancer survivors.
Fig 4
Fig 4. Forest plot of risk estimates from observational studies of weight loss and mortality outcomes in non-overweight (BMI <25) breast cancer survivors.
See this image and copyright information in PMC

References

    1. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9· 1 million participants. The Lancet. 2011;377: 557–567. - PMC - PubMed
    1. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective [Internet]. Washington DC: AICR; 2007. Available: http://discovery.ucl.ac.uk/4841/
    1. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. The Lancet. 2008;371: 569–578. - PubMed
    1. Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet. 2014;384: 755–765. 10.1016/S0140-6736(14)60892-8 - DOI - PMC - PubMed
    1. Arnold M, Pandeya N, Byrnes G, Renehan AG, Stevens GA, Ezzati M, et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol. 2015;16: 36–46. 10.1016/S1470-2045(14)71123-4 - DOI - PMC - PubMed

Publication types