Changes in Body Image and Sexuality in Rural Breast Cancer Survivors During a Weight Loss and Weight Maintenance Intervention

Abstract

This study evaluated changes in body image dimensions in breast cancer survivors after a weight control trial and predictors of those changes. Postmenopausal rural breast cancer survivors enrolled in an 18-month phone-based weight loss and weight maintenance intervention participated. Data was collected at baseline, 6-months (post-weight loss intervention), and 18-months (post-weight maintenance intervention). Participants were randomized into either a phone-based group condition or mail-based condition during the weight maintenance intervention. The Body Image and Relationships Scale (BIRS) assessed six dimensions of body image relevant for breast cancer survivors, including sexuality. All six body image subscales and total score improved upon completion of the weight loss intervention (p’s < .001). Weight loss and physical activity changes were less predictive of those improvements than age, breast cancer treatment history, and baseline depressive symptoms and quality of life. All but one BIRS dimension worsened between the weight loss and weight maintenance intervention, with a significant interaction effect by maintenance treatment condition observed for one subscale. Weight regain, marital status, breast cancer treatment history, and baseline depressive symptoms were predictive of changes in body image dimensions from 6- to 18-months. Improvements in body image dimensions during the weight loss intervention were unrelated to weight regain. Despite the worsening in body image during the weight maintenance intervention, it appears that the improvements gained during the weight loss intervention, regardless of the amount of weight lost, were only partially attenuated during weight regain.