Telephone-Based Weight Loss Intervention Improves Physical Function and Quality of Life in Early-Stage Breast Cancer

A telephone-based weight loss intervention delivered across hundreds of oncology practices significantly improved physical function and multiple quality-of-life domains among women with early-stage breast cancer (搜索)搜索该疾病 and overweight or obesity (搜索)搜索该疾病, according to findings from the health outcomes (HO)-1 substudy of the phase III Breast Cancer WEight Loss (BWEL) trial presented at the 2026 ASCO Annual Meeting.

The benefits—spanning physical, mental, and social well-being—were maintained throughout the full 2-year intervention period, demonstrating the durability of a remotely delivered lifestyle program in a large, geographically diverse patient population.

“The BWEL program was delivered to more than 1,500 participants enrolled from across 635 oncology practices in the U.S. and Canada,” said presenting author Jennifer A. Ligibel, MD, FASCO, Director of the Leonard P. Zakim Center for Integrative Therapies and Healthy Living at Dana-Farber Cancer Institute查看公司主页. “These findings thus show not only that weight loss provides meaningful benefits for people who have both breast cancer (搜索)搜索该疾病 and obesity (搜索)搜索该疾病, but also that this can be achieved in thousands of patients enrolled across many kinds of oncology practices.”

Julie R. Gralow, MD, FACP, FASCO, Chief Medical Officer and Executive Vice President of ASCO, added: “The BWEL study is challenging us to stop viewing lifestyle interventions as just optional add-ons and start integrating them as standard components of a comprehensive survivorship care plan.”

Study Design and Population

A total of 3,180 patients were enrolled between 2016 and 2021. Eligibility criteria included stage II to III hormone receptor–positive/HER2-negative breast cancer (搜索)搜索该疾病 or triple-negative breast cancer, diagnosis within the previous 14 months, completion of surgery and any indicated chemotherapy and/or radiation therapy, and overweight or obesity (搜索)搜索该疾病 (body mass index ≥ 27 kg/m²). Participants were randomly assigned in a 1:1 ratio to receive health education either alone or in combination with a telephone-based weight loss intervention.

The intervention paired each patient with a Dana-Farber–based weight loss coach and included up to 42 telephone sessions delivered over 2 years. Patients received individualized calorie goals designed to produce a 500- to 1,000-kcal/day deficit and achieve approximately 10% weight loss, while gradually increasing moderate-intensity physical activity to 225 minutes per week. Prior findings showed that patients assigned to the intervention lost 5.7% of their baseline body weight at 12 months.

The HO-1 substudy enrolled the first 542 randomly assigned patients (intervention: n = 272; control: n = 270). Patient-Reported Outcomes Measurement Information System (PROMIS)-29 Profile v2.0 and PROMIS Global Health scores were collected at baseline and at 6 and 24 months. The primary outcome—mean physical function—was assessed at 6 months using analysis of covariance (ANCOVA), adjusted for baseline score, while longitudinal mixed-effects modeling evaluated physical function and other endpoints over time.

Impact on Physical Function

Based on the ANCOVA model at 6 months, patients who received the weight loss intervention demonstrated a significant improvement in physical function compared with those in the control group (mean between-group difference = 1.9 points; P < .001). Longitudinal modeling showed that the improvement was maintained through the 2-year intervention period, with significant findings observed at both 6 and 24 months.

Broader Quality-of-Life Benefits

At 6 months, patients in the intervention group experienced significant improvements in global physical health (mean between-group difference = 2.0 points; P < .001), global mental health (1.3 points; P = .03), social roles and activities (2.3 points; P < .001), and fatigue (−1.7 points; P = .01) compared with the control group. No significant improvements were observed in anxiety, depression, sleep disturbance, or pain interference.

Longitudinal modeling analyses revealed that significant improvements in global physical health, global mental health, and social roles and activities were sustained throughout the 2-year intervention period. In contrast, the significant improvement in fatigue observed at 6 months was no longer evident at 24 months.

Clinical Implications and Expert Commentary

“The weight loss intervention was successful in inducing durable improvements in physical function, global physical and mental health, and social functioning,” Dr. Ligibel concluded. She added that investigators will continue to follow patients to determine whether these benefits may translate into improved invasive disease–free survival and other outcomes.

Marcin Chwistek, MD, FAAHPM, Director of the Supportive Oncology and Palliative Care Program at Fox Chase Cancer Center and an ASCO expert in supportive care, commented: “A program that improves survival and quality of life simultaneously is a program worth delivering.”

Dr. Gralow noted that, even in the absence of survival outcomes data, “the immediate benefits to physical function, fatigue reduction, and quality of life are undeniable.” She also emphasized that phone-based coaching reduced geographic and logistical barriers, demonstrating that significant lifestyle changes can be achieved without weekly visits to a specialized clinic. “We need to advocate for resources, insurance reimbursement, and accessible programs that allow every breast cancer (搜索)搜索该疾病 survivor the opportunity to thrive postdiagnosis,” she added.

The study was funded by the National Cancer Institute查看公司主页/National Institutes of Health, with additional support from the Breast Cancer (搜索)搜索该疾病 Research Stamp Fund, the Susan G. Komen Breast Cancer Foundation, the Breast Cancer Research Foundation, and the American Cancer Society.