title: The use of novel technology-based weight loss interventions for obese women with endometrial hyperplasia and cancer.
abstract: OBJECTIVE
  Obesity significantly increases the risk of the development of both endometrial hyperplasia and cancer. Our objective was to assess the feasibility of two technology-based weight loss interventions in this patient population.
  
  
  METHODS
  Women with obesity (BMI≥30kg/m(2)) and endometrial hyperplasia or Type I endometrial cancer were randomized 1:1 to a technology-based 6month lifestyle intervention via either telemedicine or text messaging. The telemedicine arm received weekly phone calls, with weights tracked online using Withings© Wi-Fi scales. The text arm received 3-5 personalized messages daily via Text4Diet™. Participants maintained a 1200-1800calorie/day diet, self-monitored food intake and received exercise goals. Biomarkers (IGFBP-1, adiponectin, VEGF, IL1-beta, IL2, IL6, and IL7) were assessed pre- and post-treatment.
  
  
  RESULTS
  Twenty women were randomized (Telemedicine: n=10, Text4Diet: n=10), and 90% lost weight. Many were early stage (70%) and grade (43.8%) disease with a median age of 60.5years. We observed a statistically greater weight loss in the Telemedicine arm [median loss: 9.7kg (range: 1.6-22.9kg)] versus 3.9kg (range: 0.3-11.4kg) in the Text4Diet arm (p=0.0231). Similarly, percent weight loss was greater in the Telemedicine (7.6%) as compared to the Text4Diet arm (4.1%, p=0.014). Mean serum levels of IL-2 were significantly (27.15pg/mL vs. 5.18pg/mL, p=0.0495) lower at intervention end as compared to baseline.
  
  
  CONCLUSIONS
  A technology-based weight loss intervention is feasible in women with Type I endometrial cancer/hyperplasia. Both interventions produced weight loss, although more person-to-person contact produced more significant outcomes. Reductions in expression of IL-2 were related to weight loss.
authors.affiliation: Division of Gynecologic Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: ashley.haggerty@uphs.upenn.edu.
authors.forename: Ashley F
authors.initials: AF
authors.lastname: Haggerty
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States.
authors.forename: Sarah
authors.initials: S
authors.lastname: Huepenbecker
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, 3535 Market St., Suite 3021, Philadelphia, PA 19104, United States.
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, 3535 Market St., Suite 3021, Philadelphia, PA 19104, United States.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Spitzer
authors.affiliation: Department of Psychology, Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104, United States.
authors.forename: Greer
authors.initials: G
authors.lastname: Raggio
authors.affiliation: Division of Gynecology, Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA 19111, United States.
authors.forename: Christina S
authors.initials: CS
authors.lastname: Chu
authors.affiliation: Division of Gynecologic Oncology, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States.
authors.forename: Emily
authors.initials: E
authors.lastname: Ko
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, 3535 Market St., Suite 3021, Philadelphia, PA 19104, United States.
authors.forename: Kelly C
authors.initials: KC
authors.lastname: Allison
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D004714:Endometrial Hyperplasia / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism* / Q000523:psychology / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D060145:Text Messaging; D061217:Weight Reduction Programs / Q000379:methods*
chemical_list: D014408:Biomarkers, Tumor
keywords: Biomarkers; Endometrial cancer; Obesity; Technology-based intervention; Weight loss intervention