How to Avoid Weight Gain After Breast Cancer

A healthy weight is a worthy—and important—goal for breast cancer survivors. Here’s how to achieve and maintain it.

There’s a reason that “at least you have your health” is a cliché—and if you’ve faced a serious health threat like breast cancer, the words may ring even truer for you than for other people. But just because you’ve received a clean bill of health doesn’t mean life will automatically go back to the way it was pre-cancer: It’s time to learn how to take care of your newly cancer-free body.

According to American Cancer Society guidelines for survivors, living a healthy lifestyle—which includes making smart dietary choices and being active—may be essential to helping prevent recurrence. And that means it’s crucial to address one of the potential side effects of cancer treatment that often doesn’t get much attention: weight gain.

It’s like adding insult to injury. Breast cancer patients who’ve undergone chemotherapy are about two times more likely to gain 11 or more pounds within five years post-treatment than are women who are cancer-free, according to a study in Cancer Epidemiology, Biomarkers & Prevention. And a Canadian study found that women gained 4 to 13 pounds in the first year after being diagnosed.

If you’ve been treated for breast cancer, you know why patients may be vulnerable to weight gain. Chemotherapy may interfere with your metabolism or throw you into temporary menopause. Fatigue could sap your motivation to stay active. And no matter how much of a warrior you become in your breast cancer fight, there’s no denying the psychological burden that might lead to emotional eating.

Why Your Weight Impacts Your Breast Cancer Risk

The number on the scale is a big factor in any breast cancer discussion. Obesity is often linked to increased risk of conditions such as type 2 diabetes or heart disease, but excess weight has also been shown as a risk factor for developing breast cancer specifically—and as a characteristic that affects your long-term survival.

“With breast cancer risk, it’s the actual fat tissue we have to worry about,” says Cheryl Rock, PhD, a professor of family medicine and public health at the University of California, San Diego who has led research on breast cancer survivors. Excess fat may contain higher levels of estrogen, she says, which could stimulate tumor growth. It also has increased levels of other hormones and inflammatory molecules that may be associated with breast cancer.

A recent analysis of 82 studies involving more than 200,000 breast cancer patients found that premenopausal women who were obese at the time of diagnosis had a 75 percent greater chance of dying from breast cancer and other causes compared with women with a normal body-mass index (BMI). (It’s a 34 percent increase for postmenopausal women.) And the risk went up for every 11 pounds a woman gained more than a year after diagnosis.

That means that beating the disease—as big a triumph as it is—may not be a guarantee of long-term health. “Being overweight may increase the risk of breast cancer recurrence,” explains Colleen Doyle, MS, RD, managing director of nutrition and physical activity for the American Cancer Society. “You may see your risk go up from gaining just 5 to 10 percent of your body weight.”

Achieve and Maintain a Healthy Weight

Admittedly, it’s challenging enough just to beat breast cancer. Now you have to think about reaching a healthy weight, too? But the effort is worth it, says Doyle. Losing the extra pounds might not only protect you from recurrence, but also may help you build confidence and set new goals—important tasks to get back on the road to mental recovery.

And steady, healthy weight loss is possible. Rock recently led a trial of nearly 700 overweight or obese breast cancer survivors who had begun treatment nearly two years earlier. The women who followed a reduced-calorie diet and exercised an hour daily lost, on average, 6 percent of their body weight within a year. “Exercise is critical because it helps promote retention of muscle mass and may help women maintain the weight they’ve lost,” says Rock. (The American Cancer Society recommends fitting two strength-training sessions plus 150 minutes of moderate physical activity or 75 minutes of vigorous activity into your week.)

When it comes to healthier eating, the SmartPoints system in the WW program works harder for you than simply counting calories. It nudges you toward nutritious foods that fuel you, such as fruits, veggies, whole grains, low-fat dairy, lean meats, legumes, and healthy oils. Every food is assigned its own SmartPoints value—an easy-to-use number based on four components: calories, saturated fat, sugar, and protein. You will be assigned a Daily Target each day and staying within this Target can help you lose weight at a safe rate of up to 2 pounds per week. Also, members receive constant accountability and support from a variety of sources: at Workshops, from coaching available 24/7, and on the WW Connect app, where members share successes, challenges, and inspiring stories of life on plan.

Even if losing weight sounds like a daunting addition to your recovery to-do list, Doyle suggests how to make it as easy on yourself as possible. Start with small changes that will help you feel in charge of your health again. “When you were going through treatment, there were so many things going on in your life that you couldn’t control,” she says. “But having the opportunity to take back control of your life and positively affect your health will be a huge step forward for you.”

For more information about what a healthy diet looks like, read this.