(P13-037-23) Changes in Dietary Patterns Among Breast Cancer Survivors Using a Mobile Behavior Change Program for Weight Loss: A Prospective Single-Arm Pilot Study

Objectives: Following a breast cancer diagnosis, weight gain occurs among 50-96% of survivors and increases risk of recurrence, breast cancer death, and all-cause mortality. Behavioral modification can support survivors in avoiding post-diagnosis weight gain, though studies demonstrate challenges in sustaining long-term adherence. Digital long-term interventions are needed, especially with the ongoing COVID-19 pandemic. We designed a study to examine the effects of the Noom intervention on weight, diet patterns, and physical activity.

Methods: This was a prospective single-arm pilot study in stage I-III breast cancer patients with a body mass index ≥27.5 kg/m². As part of the digital Noom platform, participants were provided with behavioral therapy tools and recorded food intake and physical activity for 24 weeks. The primary endpoint was change in weight and the secondary endpoints included change in physical activity, diet, and engagement with the application. Food records were analyzed in Nutrition Data System for Research using 2 non-consecutive days of intake during month 1 and 2 non-consecutive days during months 3-6.

Results: Of 31 patients enrolled, mean weight change was -4.8 kg (p < 0.001). Average weekly step count increased from 16,740 to 27,236 (p=0.007). Mean daily caloric intake did not change significantly (p=0.779). There were no significant changes in consumption of added sugar (p=0.771), fruits (p=0.095), vegetables (p=0.751), and whole grains (p=0.533). Engagement metrics were associated with ≥5% weight loss. On average, patients who lost ≥5% of their initial weight (N=11) logged 342 more meals (p=0.001) and logged more weights (p=0.001), compared with patients who lost < 5% weight (N=20).

Conclusions: A digitized behavioral intervention induced weight loss in breast cancer survivors predominantly via increased energy expenditure. Over the course of the intervention, food logging significantly declined in patients that experienced < 5% weight loss. While additional statistical modeling will be conducted, future research should address methods to improve reporting adherence among patients that do not achieve target weight loss in order to better tailor the intervention.

Funding Sources: This work was supported through a National Institutes of Health/National Cancer Institute Cancer Center Support Grant.