Intentional Weight Loss and Associated Cancer Incidence Among People With Overweight or Obesity: A Systematic Literature Review

Abstract

Aims

While obesity is linked to increased cancer risk, evidence on the impact of intentional weight loss on obesity-associated cancers (OACs) is limited. A systematic literature review (SLR) was conducted to assess the association between intentional weight loss and cancer incidence, including overall cancers and 13 OACs, from recent observational studies and clinical trials.

Methods

Studies published between January 2019 and May 2023 were searched within MEDLINE, EMBASE, and CENTRAL. Studies assessing the relationship between intentional weight loss, defined as weight reduction via metabolic-bariatric surgery (MBS) or lifestyle interventions, and cancer incidence were included. A dual independent review process was used to screen 1954 abstracts and 84 full-text articles, and to extract data from 18 full studies. All discrepancies were resolved by another reviewer.

Results

Of the 18 studies included, 17 studies were observational, focusing on MBS as the method for achieving weight reduction. One randomised controlled trial examined the effect of intensive lifestyle intervention on weight reduction and found no significant association between intentional weight loss and cancer risk. Intentional weight loss was associated with decreased cancer incidence in 71.4% (n = 5/7) of studies for all cancers and 66.7% (n = 4/6) of studies for OACs, with reported risk reductions of 11% to 33% and 11% to 41%, respectively. For specific OACs, a greater number of studies indicated that weight reduction was associated with reduced occurrence of endometrial (4/4, 100%, 31%–53% risk reduction), female breast (5/9, 55.6%, 19%–50% risk reduction) and colorectal (4/7, 57.1%, 20%–60% risk reduction) cancers.

Conclusions

This SLR highlights the potential cancer risk-reduction benefit of weight reduction for people with obesity.