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Mirage News
Mirage NewsHealth18 Aug 2026 3:58 am AESTDate Time
Johns Hopkins Medicine
A personalized approach to obesity treatment may help breast cancer survivors improve their long-term health by identifying early which patients need more than behavioral lifestyle intervention alone, according to a Johns Hopkins Kimmel Cancer Center-led clinical trial
The phase II Adaptive Nutrition and Exercise Weight Loss (A-NEW) trial found that breast cancer survivors who did not achieve clinically meaningful weight loss after two months of a structured nutrition and exercise program were significantly more likely to reach that goal after an FDA-approved anti-obesity medication was added to their treatment plan. The findings, reported Aug. 4 in Clinical Cancer Research, suggest that assessing patients’ early response to behavioral therapy can help clinicians tailor obesity treatment rather than relying on a one-size-fits-all approach.
Obesity affects more than 1 in 3 breast cancer survivors, and it is associated with an increased risk of cancer recurrence, cardiovascular disease, poorer quality of life and premature death. Although nutrition and physical activity programs are the foundation of weight management, many survivors are unable to lose enough weight through lifestyle changes alone
“Many breast cancer survivors strive to lose weight after treatment because they know it can improve their long-term health, but lifestyle changes alone don’t work for everyone,” says Jenni Sheng, M.D., assistant professor of oncology and study leader. “Our study suggests we don’t have to take a one-size-fits-all approach. By identifying early who isn’t responding to behavioral therapy alone, we can personalize treatment and offer additional tools that help more survivors achieve meaningful weight loss and potentially reduce their risk of future health problems.”
The A-NEW study enrolled women with stage 0–III breast cancer who were overweight or had obesity. All participants completed a comprehensive six-month behavioral weight-loss program that included individualized nutrition counseling, physical activity guidance, remote coaching and self-monitoring. After two months, investigators evaluated participants’ progress. Women who had already lost at least 5% of their body weight continued the lifestyle program alone. Those who had not met that threshold were prescribed the FDA-approved medication naltrexone/bupropion and continued the behavioral intervention.
Among the 53 participants evaluated after two months, nearly 72% had not achieved the 5% weight-loss benchmark through lifestyle intervention alone. After medication was added, 42% of those early nonresponders achieved clinically meaningful weight loss by six months. Participants who responded to behavioral intervention alone lost an average of 10.8% of their body weight, while those receiving the adaptive combination approach lost an average of 5.1%
Beyond weight loss, participants who achieved at least a 5% reduction in body weight reported improvements in physical function and pain. Investigators also observed improvements in important cardiometabolic risk factors, including hemoglobin A1c and triglyceride levels, among participants receiving the adaptive treatment strategy
Researchers found that Black participants, younger women and premenopausal women were more likely to experience slower initial weight loss, underscoring the need for individualized obesity treatment strategies and additional research to better understand barriers to successful weight management in these populations
The medication was generally well tolerated. Gastrointestinal side effects, including constipation and nausea, were the most common adverse events, and only one participant discontinued treatment because of medication-related side effects
Although the study was relatively small and not designed as a randomized comparison, investigators believe it is the first prospective clinical trial to evaluate an adaptive treatment strategy that uses early weight-loss response to guide the addition of an FDA-approved anti-obesity medication in breast cancer survivors. Larger randomized studies will be needed to confirm the findings and determine whether similar approaches using newer obesity medications can further improve outcomes
The current study builds upon earlier breast cancer-related weight-loss studies by other Kimmel Cancer Center researchers, such as the Practice-based Opportunities for Weight Reduction (POWER)-remote study
In addition to Sheng, other researchers participating in the study were Marianna Zahurak, Faith Too, Amanda Montanari, Jennifer Trost, Mengyang Lu, Young Lee, Sheetal Parida, Amanda Blackford, Dipali Sharma, Marci Laudenslager, Claire Snyder, Janelle Coughlin, and Vered Stearns
The ANEW study was funded by the NCCN Foundation, the American Institute for Cancer Research, the Breast Cancer Research Foundation, the Maryland Cigarette Restitution Fund, the National Capital Cancer Research Fund, the National Institutes of Health grant P30 CA006973, and Under Armour
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