Comparing Outcomes of a Digital Commercial Weight Loss Program in Adult Cancer Survivors and Matched Controls with Overweight or Obesity: Retrospective Analysis

Abstract

Maintaining a healthy weight is beneficial for cancer survivors. However, weight loss program effectiveness studies have primarily been in highly controlled settings. This is a retrospective study exploring real-world outcomes (weight loss and program engagement) after use of a digital commercial weight loss program (Noom) in cancer survivors and matched controls. All participants had voluntarily self-enrolled in Noom. Weight and engagement data were extracted from the program. Cancer-related quality of life was secondarily assessed in a one-time cross-sectional survey for survivors. Controls were a sample of Noom users with overweight/obesity who had no history of cancer but 0–1 chronic conditions. Primary outcomes were weight change at 16 weeks and program engagement over 16 weeks. Engagement included frequency of weight, food, and physical activity logging, as well as number of coach messages. Multiple regression controlling for baseline age, gender, engagement, and BMI showed that survivors lost less weight than controls (B = −2.40, s.e. = 0.97, p = 0.01). Survivors also weighed in less (survivors: 5.4 [2.3]; controls: 5.7 [2.1], p = 0.01) and exercised less (survivors: 1.8 [3.2]; controls: 3.2 [4.1], p < 0.001) than controls. However, survivors sent more coach messages (survivors: 2.1 [2.4]; controls: 1.7 [2.0], p < 0.001). Despite controls losing more weight than cancer survivors (−7.0 kg vs. −5.3 kg), survivors lost significant weight in 4 months (M = −6.2%). Cancer survivors can have success on digital commercial programs available outside of a clinical trial. However, they may require additional support to engage in weight management behaviors.

Evaluation of a mobile behavior change program for weight loss in breast cancer survivors

“…Engagement metrics in our trial compare favorably with prior studies in mixed or other cancer populations 28 – 30 . In a retrospective cohort that included survivors of any cancer, the number of weekly meals logged (median 26, IQR 19–33), articles read (median 25, IQR 11–28), and messages sent to coaches (median 2, IQR 0–3) were similar to usage metrics in our trial population 30 . Greater usage of the application was associated with achieving ≥5% weight loss in our study, which is consistent with data from patients with colorectal polyps 28 .…”

“…Use of the Noom application has been reported to improve diet quality leading to weight loss and reductions in total body fat, visceral fat, and waist circumference, and improvements in metabolic factors such as blood pressure, fasting glucose, and lipids 23 – 27 . Observational data suggest that the program also promotes weight loss, physical activity, healthy eating habits, and quality of life among individuals that reported a history of cancer 28 – 30 . Additional preliminary data supporting the use of smartphone apps for weight loss and maintenance in cancer populations are promising but sparse.…”

“…Additional preliminary data supporting the use of smartphone apps for weight loss and maintenance in cancer populations are promising but sparse. In a retrospective analysis of 107 cancer survivors, 70 of whom had breast cancer, use of the Noom app resulted in mean 4.7 kg (6.2%) weight loss at 4 months 30 . In a randomized controlled pilot trial of 65 patients with colorectal polyps, use of the Noom app led to a greater reduction in weight at 3 months compared to control (−1.25 vs. −0.42 kg, P < 0.01) 28 .…”

Predictive capacity of COVID-19-related risk beliefs on weight management behaviors on a commercial weight loss program and speed of COVID-19 vaccination uptake: prospective cohort study

“…Another important point about the time period is that data collection occurred shortly after New Years, which raises the possibility that this was a less motivated or successful sample for long-term weight loss for those focused on New Years resolutions [33]. However, average weight loss for this sample was similar to that of Noom samples who signed up during other parts of the year [34,35]. Still, there could be other potential differences depending on the time period in which this data was collected, so future research should ascertain the extent to which the results of this study generalize to other populations and time periods.…”

Navigating the Shadows: Understanding and Managing Persistent Somatic Symptoms in Cancer Survivors

“…Other authors also identified appetite loss as a part of a cluster of symptoms in breast cancer survivors, indicating its impact on their quality of life [75]. Research highlighted the importance of maintaining a healthy weight for cancer survivors, emphasizing the potential benefits for their overall well-being [76]…”