This story was written by Jennifer Nachbur of the Larner College of Medicine at the University of Vermont and originally published on the school’s website.
Weight loss can be challenging for anyone, but in particular, for cancer patients whose treatments can make the task even more daunting. But second-year medical students Lauren Donnelly and Kirsten Martin are having impressive – and unexpected – success helping one group of female cancer survivors achieve their weight loss and activity goals. This is thanks to a 12-week weight management program they have been delivering to patients in the Steps to Wellness oncology rehabilitation program at the University of Vermont Cancer Center.
Donnelly and Martin are recipients of a 2017-18 Schweitzer Fellowship – a one-year interdisciplinary, mentored fellowship program focused on health-related community service and leadership development through a project that provides health service to underserved populations. With nutrition analysis training from Steps to Wellness dietician Caryn Davis, M.S., R.D., and mentorship from Steps to Wellness co-directors Kim Dittus, M.D., Ph.D., and Patricia O’Brien, M.D., the students are eight weeks into conducting a 12-week behaviorally-based intervention for 17 female cancer survivors with a BMI (Body Mass Index) of greater than 30. The program, called Step Up!, features weekly, hour-long classes at the UVM Medical Center’s rehabilitation gym on Tilley Drive, and individual mentoring from Donnelly and Martin for each participant. The program uses journaling, calorie and exercise goals, and individualized feedback to help participants make lifestyle changes that they will be able to carry with them well after completing the 12-week program.
To date, their weekly Monday evening sessions with the group have included lessons on recipe renovation, goal-setting, lifestyle exercise vs. programmed exercise, portions, and food label lingo. Just before each weekly session, participants do a weigh-in, then the students check-in with attendees about how the strategies are working and to answer any questions. The lessons are interactive and include an activity that relates to each day’s focus. In one class, everyone examined a sample recipe and contributed ideas for changing it to be healthier. In addition to setting individual weekly goals for exercise and calories, the group creates shared goals and shares advice.
“The group of patients that they are working with all have a very high BMI and cancer” and weight reduction programs can be challenging in this population, says O’Brien, an internal medicine specialist and cancer survivor herself. “The Fellows are really serving the community with enthusiasm, compassion and good solid information” and, she adds, “they are so full of energy and support that these ladies have as a group lost more than 130 pounds!”
Each week, participants follow individualized calorie and fat goals and journal their meals in the MyFitnessPal app – a free online food/exercise app. Participants are expected to journal every meal and all exercise throughout the week to ensure success in the program. The group works up to an exercise goal of 300 minutes per week, with up to 10,000 steps per day for those who can walk, says Donnelly. Those who can’t walk have the option of swimming, rowing, or other low impact activities.
“We love it – it’s our favorite part of the week,” admits Donnelly, who says she and Martin have thoroughly enjoyed working with the women in the program. “We feel fortunate to have recruited such a motivated and positive group of women to participate in this program,” says Martin, who adds that she and Donnelly have benefited from the program as well, in terms of supplementing their nutrition knowledge and gaining hands-on experience counseling patients through weight loss.
“This program is way beyond what I ever expected,” says one participant, who tried six other weight loss programs before Step Up! and says this one is the best. “They work to meet each of our needs, making it very doable and informative. Both women have beautiful bedside manners – they really listen and they really care; I’m going to hate to have it end.”