For some women, breast cancer treatments and medications lead to weight gain. Trying to find the “right” diet that keeps you both thin AND healthy throughout your breast cancer experience not only gets confusing, it can feel like a life or death decision.

A couple of weeks back I received this email:

Hi Cathy,

I am one-year post-breast cancer diagnosis and struggling with healthy eating for the past 5 months.

I was at first very strict, afraid to eat and stressing about anything I ate. Now I am going crazy and eating crappy foods with too much sugar. Do you have any suggestions for me on how to find that balance? Thank you.

I’m so grateful to the person who sent this my way. It’s a question that speaks to the real struggle many women in the breast cancer community have.

I’ve worked as a nutrition therapist for 20 years and have seen this scenario countless times. While this struggle with healthy eating comes about for a variety of reasons, for women moving through the breast cancer world, it generally stems from two things:

  1. A lack of knowledge about WHAT foods to eat.
  2. A desperate need for CONTROL.

Let’s look at them each independently, then I’ll wrap up with a list of ways to regain a healthy balance.

Lack of Knowledge About WHAT Foods to Eat

Even without a breast cancer diagnosis, many women struggle with this question:What’s best to eat for my health?”

In my experience, this is code for “weight loss.” If you’re over the age of five, you truly know what the best foods are for your health: lots of fruits and veggies, lean protein, healthy fats, complex carbohydrates, fiber and calcium (that’s not all-inclusive, but it’s a solid start.)

But that’s a boring nutrition message that doesn’t promise us anything spectacular (like tons of rapid weight loss) in return, so people tend to discard that message and continue their search for the magic bullet.

Just so you know?


That message won’t change. The research supporting a plant-based diet only continues to grow, so if you want to know what’s good for you to eat, start by following that advice.

The problem is, women are weaned on the message that being thin at all costs is the health goal. In this mindset, doing battle with true physiological hunger cues for your entire life is normal and expected.

We’re bombarded with so many different “diet” messages, that it’s easy to get overwhelmed and confused. One week it’s the Mediterranean diet, then it’s the DASH diet. The week after that it’s a push to “go vegan.” Behind each new diet is the thinly veiled promise of the holy grail. . .weight loss!

For some women, breast cancer treatments and medications lead to weight gain. Trying to find the “right” diet that keeps you both thin AND healthy throughout your breast cancer experience not only gets confusing, it can feel like a life or death decision.

When you’re first diagnosed, every decision about what to eat feels scary, as if making the “wrong” choice will somehow jeopardize your health, treatment response, and even recovery and recurrence risk.

This thinking can be so powerful and persuasive that you begin to question even the truly healthy food choices, like fruit. Maybe you heard bananas have a lot of calories, too much “sugar”, or that the high levels of potassium will somehow interfere with your chemo treatments.

It’s so easy to go down that path in your mind, that the natural response is to drastically limit or even eliminate any food that appears even the slightest bit “unhealthy.”

Sadly, everything on that list tends to be foods you enjoy, so naturally, it’s not long before a feeling of deprivation sets in.

And that, my friends, is a way of eating and living that’s simply unsustainable.

A Desperate Need for Control

Because this woman is one-year post-diagnosis and has been struggling with healthy eating for five months, it suggests to me that she was most strict and fearful about food at a time that coincided with her active treatment; when everything feels out of control and overwhelmingly urgent.

Being in active treatment is like being in a building when the fire alarm goes off – and getting stuck there – for months.

The need to feel “in control” during those urgent months makes perfect sense. Unfortunately, exerting such tight control over food can accelerate the deprivation train she’s already on, rendering food choices even more limited.

But guess what?

Active treatment doesn’t last forever.

Once all the medical appointments, lab tests, EKG’s, surgeries, radiation and/or chemotherapy sessions are over, that alarm goes silent, and we tend to relax ever so slightly.

That’s when the tight control over food begins to loosen, and the pendulum of severe restriction can swing dramatically far in the opposite direction. That’s when it feels like eating is out of control, especially for those foods labeled “off limits.”

How to Find Balance in Your Eating Pattern

  • Your pattern of eating is much more important than any one single food.
    • Aim to eat a nourishing diet most often, but remember to leave room for “treat” foods.
  • Research supports plant-based diets ARE beneficial, but that doesn’t mean you must eat a 100% vegan diet.
    • Most women could easily put more plants on their plates, and that’s a good start for healthier eating. Push meat and other animal foods to the side of the plate, and fill up on fruits, veggies, nuts/seeds, and plant-based proteins if you’re up for it. Only go the completely vegan route if you want to!
  • Sugar doesn’t cause breast cancer.
    • Uncontrolled levels of insulin or blood sugar from ALL carbohydrates play a role in potentially increasing breast cancer risk. Work to get your blood sugar under control with exercise, which helps your body get better at “handling” carbohydrates, and awareness of ALL sources of carbohydrate.
  • Keep “treat” foods in your diet.
    • There’s no way you can cut out your favorite foods forever, so aim to eat smaller portions and avoid the “all or nothing” mentality.
  • Learn what foods make you feel best.
    • Health-supportive foods that give you energy, support your immune system and a healthy gut microbiome tend to come from the list in bullet point #2.
    • Try building your daily meals around those foods, paying attention to how different foods and food combinations make you feel. Generally, highly nutritious foods make you feel highly energetic and healthy!
  • Lose the “good food/bad food” mindset.
    • When you categorize foods as “good or bad”, YOU end up labeling yourself “good” or “bad.” You’re not, and neither is the food.
  • Regardless of your body weight or where you are in treatment, focus on quality, nutrient-dense choices.
    • Some days you may only want a steady diet of croissants with jam and mugs of hot, sweet tea. Allow yourself to do that without berating yourself. Be aware, but recognize that it won’t last forever. When you DO feel like fueling better, go for quality and nutrition (whole wheat croissant?)

The Heart and Breast Health Connection

Because I’ve been writing this month about the heart and breast health link, you may be wondering how this topic fits.

When your food intake swings from one extreme to the other, your weight tends to follow. This is known as “weight cycling” or “yo-yo dieting.”

Some (not all) research suggests that weight cycling and the accompanying fluctuations (which may overshoot normal lab values) of cardiovascular risk variables like blood pressure, heart rate, blood glucose, lipids, and insulin could put additional stress on the cardiovascular system. (1)

TAKE HOME MESSAGE: maintaining a healthy body weight has been shown to reduce the risk of both heart disease and breast cancer. Dieting and the pursuit of weight loss have potential side effects that aren’t often talked about. It’s better to focus on healthy behaviors, regardless of weight, than to focus on weight loss/maintenance by any means.


Want to know which foods are best to include in your breast cancer (and heart healthy) diet? To create your OWN customized nutrition plan, CLICK HERE.

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Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?