Lee Eun-Gyeong, Lee Dong-Eun, Kim Jeongseon, Han Jaihong, Lee Seeyoun, Kang Han-Sung, Lee Eun Sook, Chae Heejung, Sim Sung Hoon, Lee Keun Seok, Lee Jungeun, Lee Hyun Jeong, Yoo Ji Sung, Wie Gyung Ah, Jung So-Youn
Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, 10408, Republic of Korea, 82 31-920-1681, 82 31-920-2799.
JMIR Mhealth Uhealth. 2025 Sep 24;13:e64846. doi: 10.2196/64846.
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.
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.
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.
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.
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.
超重或肥胖是乳腺癌复发及乳腺癌相关死亡的一个预后因素。然而，由于更年期、化疗、抗激素治疗及心理问题，乳腺癌幸存者很难控制体重。
本研究旨在开发一项基于移动应用程序Noom的为期24周的人工指导计划，并评估其对超重或肥胖的乳腺癌幸存者（包括成功使用该计划的人群）的疗效。
在这项单臂前瞻性队列研究中，130名体重指数（BMI）≥25的乳腺癌幸存者入组，并在2019年至2021年期间接受了为期24周的计划，内容包括基于饮食、运动和心理方面的指导，由Noom中经过培训的人工教练提供。对于加入超过16周的活跃组，我们在基线、6个月和12个月随访时评估了体重、BMI、血脂水平、生物电阻抗和生活质量。
130名乳腺癌幸存者中，分别有101名（77.7%）和93名（71.5%）完成了6个月和12个月的随访。所有参与者的平均年龄为54.90（标准差7.42）岁。基线时，活跃组的BMI中位数为27.14（四分位间距25.20 - 35.36），活跃和不活跃组为27.50（四分位间距25.20 - 35.50）。在活跃组（68/101，67%）中，体重和BMI在6个月时显著降低（平均差值 -1.97，95%置信区间 -2.65至 -1.26 kg；P<.01；平均差值 -0.86，95%置信区间 -1.15至 -0.56；P<.01），并在12个月时保持稳定，无体重反弹效应。在血脂指标中，甘油三酯水平显著下降（-34.13，95%置信区间 -58.09至 -10.17；P<.01），并在12个月时维持该水平。关于生物电阻抗成分，前6个月骨骼肌质量（kg）、体脂质量（kg）、体脂百分比（%）、腰臀比和内脏脂肪面积（cm²）均有所改善。然而，在接下来的6个月中，腰臀比和内脏脂肪面积有所增加。基于欧洲癌症研究与治疗组织生活质量问卷核心30项（EORTC QLQ C30）和乳腺癌模块（23项），恶心或呕吐、便秘、身体形象以及手臂和乳房症状在前6个月有显著改善。
本研究表明，对于超重或肥胖的乳腺癌幸存者，一项基于移动应用程序的为期24周的人工指导计划在控制体重、BMI、甘油三酯以及生物电阻抗方面的身体成分方面是有益的。
