Impact of a 24-Week Mobile App-Based Human Coaching Program on Body Composition and Lipid Metabolism in Breast Cancer Survivors With Overweight or Obesity: Single-Arm Prospective Cohort Study.

Abstract

Background: Overweight or obesity is a prognostic factor for breast cancer recurrence and breast cancer-related deaths. However, weight control is difficult for breast cancer survivors because of menopause, chemotherapy, antihormonal therapy, and psychological issues.

Objective: This study aimed to develop a 24-week mobile app-based human coaching program using Noom and evaluate its efficacy in breast cancer survivors who are excessively overweight or with obesity, including those who successfully used the program.

Methods: In this single-arm prospective cohort study, 130 breast cancer survivors with BMI ≥25 were enrolled and received a 24-week program, including diet-, exercise-, and psychology-based content with the trained human coach in Noom between 2019 and 2021. For a hyperactive group who joined for more than 16 weeks, we evaluated weight, BMI, lipid level, bioimpedance, and quality of life at baseline, 6-month, and 12-month follow-up.

Results: Among 130 breast cancer survivors, 101 (77.7%) and 93 (71.5%) completed the 6-month and 12-month follow-ups, respectively. The mean age of all participants was 54.90 (SD 7.42) years. At baseline, the median BMI was 27.14 (IQR 25.20-35.36) for the hyperactive group and 27.50 (IQR 25.20-35.50) for the active and inactive group. In the hyperactive group (68/101, 67%), body weight and BMI significantly reduced (mean difference -1.97, 95% CI -2.65 to -1.26 kg; P<.01 and mean difference -0.86, 95% CI -1.15 to -0.56; P<.01, respectively) at 6 months and were maintained at 12 months without the yo-yo effect. Among the lipid panel, triglyceride levels decreased significantly (-34.13, 95% CI -58.09 to-10.17; P<.01) and were maintained at 12 months. With respect to bioimpedance components, skeletal muscle mass (kg), body fat mass (kg), percent body fat (%), waist-to-hip ratio, and visceral fat area (cm2) improved in the first 6 months. However, waist-to-hip ratio and visceral fat area increased during the next 6 months. Based on the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ C30) and Breast Cancer Module (23 items), nausea or vomiting, constipation, body image, and arm and breast symptoms significantly improved during the first 6 months.

Conclusions: This study demonstrated that a 24-week mobile app-based human coaching program is beneficial for controlling body weight, BMI, triglyceride, and body composition in terms of bioimpedance for breast cancer survivors who are excessively overweight or have obesity.