Weighing In: Psychological Outcomes Associated with Weight Changes Among Women Treated for Breast Cance

This mixed-methods program of research consisted of three inter-related studies to examine how changes in weight contribute to women's psychological health in the post-treatment phase of breast cancer. Study 1 employed a qualitative design and purposeful sample of weight-preoccupied women (n = 11), to explore experiences of weight-related changes post-treatment, and examines perceptions of weight throughout the cancer trajectory. In a prospective longitudinal design spanning the first-year post-treatment for breast cancer (n = 173), Study 2 examines how pre-cancer and post-treatment weight patterns impact indices of psychological health (i.e., weight-related guilt, shame, and depressive symptoms). Study 3 utilized a daily diary design of women with comorbid breast cancer and obesity (n = 52) to assess the acute emotional outcomes associated with daily self-weighing in the context of weight management. Collectively, this body of work underscored the distressing nature of both weight changes and weight management efforts, in the context of reducing risk for breast cancer. Women reported experiencing more negative emotional consequences when their weight was higher than usual, both acutely after self-weighing and chronically over time in the first-year post-treatment. It was further suggested that a history of pre-cancer weight cycling served as an additional risk factor predicting worsened psychological experiences after treatment. These findings are important given that the well-documented impact of excess weight and psychological distress on worsened cancer survival. In light of the fundamental challenges of weight management, targeting women's weight-related psychological distress after breast cancer should be a clinical priority. Recent weight-neutral paradigms and compassion-focused approaches may be useful for improving the psychological health and well-being of women across the weight spectrum, and throughout the cancer trajectory.