Clinical Study

The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial

Abstract

Background

Breast cancer diagnosis may be a teachable moment for lifestyle behaviour change and to prevent adjuvant therapy associated weight gain. We assessed the acceptability and effectiveness of two weight control programmes initiated soon after breast cancer diagnosis to reduce weight amongst overweight or obese women and prevent gains in normal-weight women.

Methods

Overweight or obese (n = 243) and normal weight (n = 166) women were randomised to a three-month unsupervised home (home), a supervised community weight control programme (community) or to standard written advice (control). Primary end points were change in weight and body fat at 12 months. Secondary end points included change in insulin, cardiovascular risk markers, quality of life and cost-effectiveness of the programmes.

Results

Forty-three percent of eligible women were recruited. Both programmes reduced weight and body fat: home vs. control mean (95% CI); weight −2.3 (−3.5, −1.0) kg, body fat −1.6 (−2.6, −0.7) kg, community vs. control; weight −2.4 (−3.6, −1.1) kg, body fat −1.4 (−2.4, −0.5) kg (all p < 0.001). The community group increased physical activity, reduced insulin, cardiovascular disease risk markers, increased QOL and was cost-effective.

Conclusions

The programmes were equally effective for weight control, but the community programme had additional benefits.

Clinical trial registration

ISRCTN68576140

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Acknowledgements

We thank the participants and the research teams in the recruiting centres.

Author information

M.H., A.H., N.B., J.W., A.C., and J.M. were involved in the design of the study. M.H., M.P., D.M., K.L., J.A., and J.W. performed data acquisition. J.M., M.H., D.M., M.P., S.H., and A.H. were involved in the statistical analysis and interpretation of data. N.B. enrolled patients. J.W., H.C., and E.L. undertook the health economic analysis. J.A. performed the interpretation of the radiological images. M.H., J.W., and J.A. wrote the draft manuscript. A.H. and M.P. helped with the manuscript editing. All authors read and approved the final manuscript.

Correspondence to Michelle Harvie.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

The study was approved by the North West 8 Research Ethics Committee—Greater Manchester East, reference 08/H1013/45. Informed consent was obtained from all subjects and the study was performed in accordance with the Declaration of Helsinki.

Funding

This project was funded by the NIHR RFPB (PB-PG-0407-12313) and Prevent Breast Cancer Limited (Registered Charity Number: 1109839, award GA08-006) and supported by the NIHR Manchester Biomedical Research Centre (IS-BRC-1215-20007). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

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Not applicable.

Data availability

All datasets used and analysed during the current study are available from the corresponding author on reasonable request.

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Harvie, M., Pegington, M., McMullan, D. et al. The effectiveness of home versus community-based weight control programmes initiated soon after breast cancer diagnosis: a randomised controlled trial. Br J Cancer 121, 443–454 (2019). https://doi.org/10.1038/s41416-019-0522-6

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