Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 28, 2024
Date Accepted: Jul 25, 2025
Impact of a 24-week mobile application-based human coaching program on body composition and lipid metabolism in breast cancer survivors with overweight or obesity: a single-arm prospective cohort study
ABSTRACT
Background:
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, anti-hormonal therapy, and psychological issues.
Objective:
This study aimed to develop a 24-week mobile application-based human coaching program using Noom and evaluate its efficacy in breast cancer survivors who are overweight or obese.
Methods:
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 contents with the trained human coach in Noom during 2019–2021. For a hyperactive group who joined more than 16 weeks, we evaluated weight, BMI, lipid level, bioimpedance, and Quality of Life at baseline, 6-month, and 12-month follow-up.
Results:
Among 130 breast cancer survivors, 101 (77.7%) and 93 (71.5%) completed the 6-month and 12-month follow-ups, respectively. In the hyperactive group (68/101, 67%), body weight and body mass index (BMI) significantly reduced (mean difference: -1.97 kg, 95% CI (confidence interval):-2.65–-1.26, P<0.001 and -0.86, 95% CI:-1.15–-0.56, P<0.001, respectively) at 6 months and maintained at 12 months without the yo-yo effect. Among the lipid panel, triglyceride (TG) levels decreased significantly (-34.13, 95% CI:-58.09- -10.17, P=0.006) and maintained at 12 months. With respect to bioimpedance components, skeletal muscle mass (SMM, kg), body fat mass (BFM, kg), percent body fat (PBF, %), waist-to-hip ratio (WHR), and visceral fat area (VFA, cm2) improved in the first 6 months. However, WHR and VFA increased during the next 6 months. Based on the EORTC QLQ C30 and BR 23, nausea or vomiting, constipation, body image, arm, and breast symptoms significantly improved during the first 6 months.
Conclusions:
This study demonstrated that a 24-week mobile application-based human coaching program is beneficial for controlling body weight, BMI, TG, and body composition in terms of bioimpedance for breast cancer survivors who are overweight or obese. Clinical Trial: ClinicalTrials.gov Identifier: NCT 05506189
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