Cancerwise

Weight loss can feel overwhelming. Cancer survivorship may make it feel even more complex. Fortunately, finding support during weight loss doesn't have to be an added challenge.

That's where Your Health is Calling, a new telehealth program for cancer survivors, comes in. This free, evidence-based telehealth curriculum combines expertise from dietitians, cancer survivors and an exercise physiologist.

Ahead, researcher Karen Basen-Engquist, Ph.D., and senior health education specialist Giselle Garza share program-approved weight loss tips for cancer survivors.

Know why it’s important

Excess body weight is a risk factor for developing 12 types of cancer, as well as chronic diseases including diabetes, heart disease and arthritis. For cancer survivors, weight is also tied to a greater risk of developing a second cancer, Basen-Engquist notes.

Researchers are exploring why excess body weight may increase cancer risk. One explanation? When cells rapidly divide, there is a greater chance of a mistake leading to uncontrolled cell growth and cancer. Excess body weight can cause inflammation, insulin resistance and increased estrogen levels, three factors that can each cause cells to multiply more rapidly.

Consult with your cancer care team

Whether or not you are a cancer survivor, the equation for weight loss is largely the same, Basen-Engquist says: using more calories than you consume. This is also called a calorie deficit.

However, she adds that cancer may change the way you approach weight loss. For example, weight loss can be a side effect of some cancers and cancer treatments, which might mean patients and their families associate weight loss with being sick.

Conversely, with some types of cancer, people tend to gain weight during or after treatment. This leaves them to navigate life after cancer and weight loss at the same time.

“I think there's a little bit of an extra frustration that they might have, although certainly weight loss is frustrating for a lot of people,” Basen-Engquist says.

You’ve probably heard the advice, “Consult with your care team,” countless times during your cancer treatment. But this advice is repeated for good reasons: your care team can provide guidance tailored to your medical history and unique needs. They can also answer questions about whether weight-loss injection drugs, or GLP-1s, or other weight loss medications might be right for you.

Find out what a healthy weight is for you

One of the first steps in weight loss? Figuring out whether you need to lose weight, and, if so, how much.

There are many ways you can determine if you are at a healthy body weight. Your Health is Calling uses Body Mass Index (BMI), and is open to people with a BMI of 25 or higher, meaning they fall into overweight or obese BMI classifications. However, BMI isn’t the only way — or necessarily even the best way — to determine whether you are a healthy weight.

“BMI is really controversial right now as far as whether it's a good measure of body fatness and a good measure of health risk,” Basen-Engquist says. This is because BMI doesn’t account for some factors that may impact weight, such as muscle mass, gender, age, ethnicity and body fat distribution.

Instead of BMI, you can also use other at-home tools such as waist circumference, waist-to-hip ratio, waist-to-height ratio and body roundness index. These options can be especially helpful in determining abdominal obesity, which Basen-Engquist says may indicate greater health risks than fat in other parts of the body.

“Abdominal obesity, the fat on your organs, does seem to increase health risks more than, say, fat in your legs, buttocks, arms and other areas,” she says.

RELATED: Is BMI the best body weight calculator?

Determine your calorie needs

Next, determine how many calories you should eat in a day.

To do so, our dietitians recommend using online calculators such as the National Institutes of Health Body Weight Planner. First, enter your current weight, sex, age, height and physical activity level. Next, enter your goal weight and the timeline you’d like to reach it in. Then, select if you plan on increasing your physical activity levels. The planner will then tell you the number of calories to eat in a day to maintain your current weight, reach your goal weight and maintain your goal weight.

“As a weight loss strategy, it's very important, especially initially, to reduce the amount of food you're eating,” Basen-Engquist says.

This means portion control is an important focus in weight loss. Some people find it helpful to keep a record of what they eat, while others use tools like food scales and portion plates, Garza notes.

Eat healthy foods

When it comes to diet, it can be easy to fixate on how much you eat. But it’s also important to consider what you eat.

The foods you choose can help impact how you feel, keep you feeling full and even impact your disease risk.

“You need to maintain adequate nutrition while losing weight,” says Basen-Engquist. This means eating a balance of protein, fats and carbohydrates, plenty of fruits and vegetables and vitamin-rich options.

MD Anderson dietitians recommend eating meals rich in whole grains, vegetables, fruits, beans, nuts and seeds. Come mealtime, this looks like filling two-thirds of your plate with whole grains, vegetables, fruits, beans, nuts and seeds. The remaining one-third can be lean animal protein or plant-based protein.

RELATED: 36 foods that can help lower your cancer risk

Stay active

The other half of the weight loss equation? Movement.

Aim for at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week. To tell the difference between moderate and vigorous exercise, try the talk test. During moderate exercise — think a brisk walk — you should still be able to hold a conversation, but you won't be able to sing. During vigorous exercise, like running, you might only be able to say a few words without feeling out of breath.