Perceptions of weight management counseling among gynecologic cancer survivors: opportunities for enhancing survivorship care

Purpose: Oncology practice guidelines recommend incorporating weight management efforts throughout survivorship care; however, some oncologists raise concerns about implementing weight management counseling without damaging patient-provider relationships. This study explores cancer survivors’ receptivity to weight management counseling and examines whether views of counseling effectiveness are associated with individual characteristics including health-related perceptions or psychological distress. Methods: Patients presenting to a NCI Comprehensive Cancer Center gynecologic oncology ambulatory clinic were asked to complete a survey assessing health and weight history, health perceptions, psychological distress, provider preferences, and weight management counseling perceptions. Results: Two hundred forty-four gynecologic cancer patients (38% endometrial, 37% ovarian, 16% cervical, 8% other) completed surveys. Mean participant BMI was 31.6 (SD = 9.6); 69% were overweight/obese. Most survivors (≥85%) agreed that oncologists should discuss healthy eating, exercise, and weight loss; only 14% reported receiving weight management counseling from their oncologist. 79% reported being more likely to attempt weight loss if counseled by a physician; 59% reported counseling would not be offensive. Regression results indicated that viewing weight management counseling as effective was associated with fewer depressive symptoms and greater enjoyment of physical activity, while viewing counseling unfavorably was associated with a history of attempting multiple weight loss strategies and an overall view of healthy behaviors as less beneficial (ps < .05). Conclusions: Most gynecologic cancer survivors want weight management counseling from oncologists and believe counseling is effective rather than deleterious, yet obesity remains inadequately addressed. Results from this study highlight important topics to be incorporated into weight management counseling.