Some research connects small, almost imperceptible lifestyle habits around food, activity and sleep to weight creep, indicating that a few extra chips here, a soda there, and a string of post-diagnosis sleepless nights (which tends to make you less likely to engage in healthy habits) can all conspire to make your pants more snug.
We breast cancer survivors are quick to express gratitude for any life-saving treatments we receive, and just as quick to bemoan said treatments for the collateral damage (thanks Dr. Susan Love) left in their wake. While the type and severity of treatment aftermath varies widely, if there’s a unified grouse among those who’ve walked the breast cancer path, it has to be weight gain.
An aftermath that I find particularly egregious, by the way.
It’s enough for a woman to experience the horror and rigor of breast cancer; must body dissatisfaction (loathing?), ill-fitting clothes and an increased risk of recurrence be part of the deal? (1)
Scientific literature confirms a connection between breast cancer treatment and weight gain, negative body image and body dissatisfaction in survivors (duh), but I can share anecdotally from women in real life that extra body weight’s stubborn reluctance to budge is frustrating at best, maddening at worst, and depressing as all hell. (2,3)
It’s Only a Little Weight Gain
Recurrence risk factors aside, you could make a strong argument for “making peace” with the extra weight. What’s a little weight gain in exchange for being alive? Isn’t it shallow to curse how your favorite pre-breast cancer jeans fit differently, given that you’re even here to complain about them?
To be clear, I’m not suggesting you disregard recommendations to lose weight if you need to. Increased recurrence risk aside, overweight and obesity are connected to diabetes, heart disease, sleep apnea and fatty liver disease, among other medical concerns. (4)
But with so many other issues to contend with; surgical complications, neuropathy, medication side effects, lack of energy, or brain fog from chemo and/or medications, devoting time and attention to weight loss can feel like an insurmountable challenge.
So rather than go down the endless rabbit hole of telling you HOW to lose the weight (which in and of itself could be the longest blog post ever written), I’d like to introduce you to the concept of WEIGHT CREEP.
What Is Weight Creep?
Weight creep, that phenomenon where the numbers on the scale gradually increase, tends to happen with age. Each new decade brings body composition changes, most notably, a decrease in calorie-hungry muscle and an increase in slothful fat. (5)
For post-menopausal women (surgically, naturally or via medication), the dramatic decrease in estrogen combined with potential changes in the metabolism of fatty tissue promotes fat gain (especially in the belly and hips) that may result in weight redistribution and body shape changes, even if the number on the scale doesn’t move too much. Some research even suggests that lipoprotein lipase, an enzyme critical to the efficient breakdown and use of fats from the diet may become less effective with the menopause-induced decrease in estrogen; all of which can lead to menopause weight fluctuation. (6)
But if weight creep is typically connected to aging, what explains weight gain in younger women diagnosed with breast cancer?
There may be a few things at play. There’s the treatment impact itself (which I explain below), carrying extra weight at the time of diagnosis, and the reality that weight creep can happen at ANY age, especially with unhealthy lifestyle habits. A study out of the Harvard School of Public Health and Brigham and Women’s Hospital followed male and female subjects over 20 years, evaluating weight changes every 4-year period. Every 4 years the participants gained an average of 3.35 pounds for a total weight gain of 16.8 pounds. (7)
Some research connects small, almost imperceptible lifestyle habits around food, activity and sleep to weight creep, indicating that a few extra chips here, a soda there, and a string of post-diagnosis sleepless nights (which tends to make you less likely to engage in healthy habits) can all conspire to make your pants more snug. (8)
Regardless of exactly which factors are at play, for women of ALL ages, we know weight gain during and/or after breast cancer treatment is all too common. If you’re of a “certain age” and experienced weight creep BEFORE your diagnosis, contending with the EXTRA challenge brought on by breast cancer can feel oh so heavy!
How Breast Cancer Treatment Causes Weight Gain
Regardless of the individual or combined treatment protocol, weight gain can be either a direct or indirect side effect (9).
Chemotherapy Weight Gain:
- cause the body to hold more water (edema)
- produce fatigue (which may lead to inactivity)
- trigger nausea (which may be managed by eating even in the absence of hunger)
- drive physiological and psychological food cravings
- send women into menopause
Steroid Medication Weight Gain:
- increase appetite
- cause an increase in fatty tissue in the abdominal area with long-term use
Tamoxifen or Aromatase Inhibitor (AI) Medication Weight Gain:
- decrease estrogen or progesterone levels
- lead to a reduction in muscle
- increase body fat
- reduce metabolic rate
- cause athralgia (joint pain)
Three HABITS That Cause Weight Creep and What to do About Them
In the breast cancer world, weight creep may be attributed to a completely different set of habits and thought patterns then the research on non-breast cancer subjects reveals. This is where our circumstances create unique weight loss challenges, but here’s the good news – you can do something about them!
Habit #1 – You decide to worry about the weight after you get through treatment. It ended six months ago.
“The extra weight can wait,” you said.
It took everything you had to get through treatment. The disruption, appointments, emotional upheaval, turmoil and chaos left you with only enough focus and energy to handle things screaming for immediate attention. Ignore them, and there were immediate consequences.
For example, skipping a doctor or physical therapy appointment, or not taking your kids to school because you didn’t feel like driving would each result in consequences.
Weight gain? No immediate consequence.
Your body’s felt crappy for so long you decide to accept it as your “new normal”, yoga pants and a t-shirt are your go-to wardrobe so who cares whether your clothes fit, and you still feel so tired that take-out has become your new personal chef.
And NOTHING bad has happened.
Solution: Forget your body, start with your mind. What belief is preventing you from taking care of yourself? Is practicing self-care and self-love not yet an automatic “thing”? While it’s true you may have some physical limitations, becoming more active could lead to noticeable improvement in how your body feels. Try gentle activity like yoga, stretching, walking or light weight lifting, and see if you don’t feel better physically; which, by the way, encourages healthier eating habits as well.
Habit #2 – You still don’t feel like exercising (nor like doing it), so you reward or justify your workouts with food.
Scenario #1 – REWARD: You promise yourself a coconut milk mocha latte and a scone as your reward for going to the gym. Every, single, time you go to the gym. The latte and scone calories add up, sometimes clocking in higher than the number of calories you burned at the gym; the scale doesn’t budge, your clothes still don’t fit.
Scenario #2 – JUSTIFICATION: You went for a 20 minute walk and did a few walking lunges; you decide to eat double helpings at dinner because you “worked out”.
Solution: Let me be clear. There is NOTHING wrong with having your favorite latte and bakery treat, nor is it against the law to eat double helpings at any meal. But you’ve got to use perspective and put the food in its proper place; as “fuel” versus “payoff”. Give yourself the gift of a NON-FOOD reward – a massage, movie, or a great book.
And if you use your workout as permission to eat (or eat more)? Stop. You don’t need to earn the right to fuel your body, and you can nourish yourself without doing penance.
Habit #3 – Planning is not your thing. Your treatment and recovery’s been so structured, you just want to “wing it.”
I know. Planning feels restrictive and like one more thing you HAVE to do, when all you WANT to do is coast for a bit. Maybe look at it as something you CHOOSE to do to make meals/snacks/shopping/cooking feel less chaotic?
Don’t get all crazy and think you need to write a week’s worth of menus or create elaborate monthly meal plans, but a little planning ahead makes everything about feeding yourself (and the people who live with you) easier and healthier. Grazing on snack foods or zipping through the drive-through is simple – but at the end of the day – do you REALLY want to live on that? I didn’t think so.
Solution: Meal “assembly” can save you. Fill your fridge and pantry with pre-packaged, frozen and fresh cut up and ready to eat veggies and fruits, microwavable brown rice and quinoa, seasoned lean meats and fish, and other proteins like pre-cooked hard boiled eggs or packages of pulses (white, black, garbanzo and kidney beans, lentils and split peas). Pull together meals and snacks from the items you have available; most only require heating up or taking straight from the fridge to plate.
Please do me a favor, would you? SHARE THIS post with other women in the breast cancer community!
And let me know in the comments below; have you experienced weight creep as a result of breast cancer? What did you do about it?
Thank you. #grateful
- Weight Gain After Breast Cancer Diagnosis and All-Cause Mortality: Systematic Review and Meta-Analysis.
- Physical and psychological outcomes among women in a telephone-based exercise intervention during adjuvant therapy for early stage breast cancer.
- Influence of Body Image in Women Undergoing Treatment for Breast Cancer.
- Health Risks of Being Overweight
- How to Stop Gaining Weight Try these tips to stop ‘weight creep’ as you get older.
- Differences in Adipose Tissue Metabolism between Postmenopausal and Perimenopausal Women
- Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men
- TV and soda: small habits cause weight creep
- Causes of weight gain during cancer treatment