To evaluate the association between clinician counseling and weight loss attempts among survivors of obesity-associated cancers compared to adults with obesity without a cancer history.
Approach:
Study Design: Cross-sectional analysis using NHANES data from 2013-2020, focusing on adults aged 20 and older with obesity and a history of IARC-defined obesity-associated cancer.
Participants: 315 adults with obesity and a history of obesity-associated cancer and 7439 comparator adults with obesity.
Data Analysis: Survey-weighted logistic regression models estimated adjusted probabilities of attempted weight loss based on clinician counseling and other factors.
Key Findings:
Counseling for weight management was not more common among cancer survivors than comparator adults.
Weight-loss attempts were less frequent among survivors of obesity-associated cancers (47.9%; 95% CI, 38.1%-57.8%) compared to nonsurvivors (59.6%; 95% CI, 57.5%-61.7%).
Counseling was associated with a 41.6-percentage point (pp) greater probability of attempting weight loss among cancer survivors (95% CI, 28.4-54.7 pp) compared to an 11.6-percentage point (pp) increase among comparator adults (95% CI, 7.7-15.5 pp).
Interpretation:
Survivors of obesity-associated cancers are less likely to receive counseling for weight management and have lower weight loss attempts, but respond more positively to counseling when it occurs.
Limitations:
Cross-sectional design limits causal inference.
Reliance on self-reported measures may introduce bias.
Lack of data on time since diagnosis, prognosis, or competing health concerns.
Conclusion:
The findings underscore the need for improved clinician engagement in weight management counseling for cancer survivors, as effective counseling can significantly enhance their likelihood of attempting weight loss. Addressing the barriers to counseling may help improve health outcomes in this vulnerable population.
