Weight gain in breast cancer patients receiving adjuvant treatment as a function of restraint, disinhibition, and hunger
Weight gain during and following adjuvant chemotherapy (Group A), adjuvant tamoxifen (Group B), and radiation therapy (Group C) was studied in a total of 73 subjects an average of 20 months after surgical treatment for breast cancer. Subjects were interviewed individually and administered the Three-Factor Eating Questionnaire, which assessed eating behavior along three dimensions: dietary restraint, disinhibition, and perceived hunger. Questionnaires were also given which assessed emotional status, psychological adjustment to illness, and body image. Weight data was obtained from medical records and a current weight obtained at the time of interview. Although it was predicted that restrained eaters in Group A would gain the most weight, there were no significant differences found in weight gain between groups. Restraint predicted weight gain in women across groups who had gained 2 or more kg for the first 6 months beginning the first day of treatment. However, after 6 months, both disinhibition and hunger appeared to predict weight gain. Disinhibition and hunger were also associated with a heavier weight at baseline. Decrease in activity level was also found to be correlated with weight gain. There was no direct association between weight gain and any of the psychological variables or change in menopausal status during treatment. However, both disinhibition and hunger were associated with negative body image and some measures of dysphoria, suggesting that psychological variables may be mediators of weight gain in this setting. These findings suggest that weight gain is not mediated by some metabolic effect of chemotherapy per se, but that women treated for breast cancer by each of these modalities may gain weight both during and after treatment. Rather, the data suggest that particular traits with regard to eating behavior may predispose some women to gain weight while undergoing or recovering from treatment for breast cancer. No differences were found between groups on body image, emotional status, or psychological adjustment to illness. Scores on questionnaires were consistent with patient interviews. Although many subjects experienced some day-to-day problems as a result of breast cancer, such as fitting prostheses, most subjects appeared to have recovered from their earlier emotional disequilibrium. A universal concern in all groups was fear of recurrence. (Abstract shortened with permission of author.).