Delay Discounting as a Potential Therapeutic Target for Weight Loss in Breast Cancer Survivors

SIMPLE SUMMARY: Obesity is a rising health epidemic in breast cancer survivors and associated with multiple negative health sequalae and increased mortality. Delay Discounting (DD) is a behavioral economic measure of an individual’s valuation of future outcomes. While higher DD correlates with obesity in the general adult population, valuation of the future may impact cancer survivors differently due to their unique experiences. We assessed cross-sectional associations between DD, BMI, and healthy lifestyle behaviors in an exploratory analysis of 89 women with hormone receptor positive non-metastatic breast cancer. We found higher DD to be associated with obesity and decreased frequency of vegetable consumption. Future studies should investigate DD as a therapeutic target for novel behavioral interventions in breast cancer survivors affected by obesity. This may improve valuation of the future, increase healthy lifestyle behaviors, and facilitate weight loss to promote overall health and longevity in this population. ABSTRACT: Obesity in breast cancer (BC) survivors is associated with increased mortality. Delay discounting (DD) is a behavioral economic measure of how individuals value future outcomes. Higher DD correlates with obesity in the general population. Valuation of the future may be associated with obesity differently in cancer survivors. This study evaluated the relationship between DD and obesity in BC survivors. We report an exploratory analysis assessing cross-sectional associations between DD, BMI, and lifestyle behaviors (vegetable and fruit consumption, exercise) related to obesity in 89 women with hormone receptor positive non-metastatic BC. Multivariate linear regression analysis examined demographic and lifestyle behavior variables associated with both BMI and DD. Greater willingness to wait for larger, delayed rewards (lower DD) was significantly associated with lower BMI (standardized beta = −0.32; p < 0.01), independent of age, race, income, time since diagnosis, and menopausal status. There was no significant association between DD and fruit consumption or exercise frequency. Vegetable consumption was significantly associated with lower DD (standardized beta = 0.24; p < 0.05). Higher DD is associated with obesity and decreased frequency of vegetable consumption in BC survivors. Future studies should investigate DD as a therapeutic target for behavioral interventions to facilitate weight loss and promote longevity in this population.