The WL4W Experience

Written by Lori Bumbaco RD, a Board Certified Specialist in Oncology Nutrition and Deborah Kronenberger MA, LCPC, a Licensed Clinical Counselor with a specialty in mindfulness

Just another Tuesday
On Tuesdays two groups of survivors meet to learn, share, and make commitments in pursuit of a healthy lifestyle. Week after week, they will address the challenges that limit their ability to achieve a healthy lifestyle, which may have preceded or was a consequence of their diagnosis and treatment. During their time together, members will gain invaluable knowledge and skills in a transition towards emotional and physical health. By the end of the program, the group will graduate with established healthy behaviors and be equipped to cultivate wellness in their lives.

The groups acquire these skills in a gradual process that simplifies an otherwise complicated maze of weight management. The groups receive a hands-on approach; they’ll receive organic fresh produce donated from a local farm, pass around spices to learn how to flavor their food with less salt, sugar, and fat, sample simple recipes prepared in the demo kitchen, and even practice yoga.

First the bad news
A significant number of cancer survivors do not meet lifestyle guidelines and are commonly inactive, have a poor diet quality, and are overweight or obese. It is speculated that these suboptimal lifestyle behaviors can become more pronounced as a consequence of their diagnosis and treatment.

Moreover, despite the growing evidence supporting safety and effectiveness of diet, exercise, and lifestyle interventions, there is a lack of available programs incorporating them. In fact, interventions are yet to become a standard of survivorship care and are not yet adequately reimbursed by insurers.

Now the good news
Cancer survivors are living longer as a result of significant development in early detection and treatment advancements. There is an increase in the 5 year survival rate, and the care survivors receive has shifted focus away from cancer related concerns towards long-term overall health goals. Experts now recommend that survivors emphasize a healthful diet and a physically active lifestyle, while maintaining a healthy weight. Doing so may reduce risk of recurrence, a second primary malignancy, as well as many other chronic diseases.

Oncology specialists are excited by preliminary research that suggests that weight loss may have the potential to influence overall outcomes and reduce risk of recurrence. This is an area of active research in the field: Assessing the Value of Weight Loss in Reducing Breast Cancer Recurrence Risk

Survivors do not need to look far to embrace the opportunity to embark on healthy lifestyle changes. Weight Loss for Wellness, affectionately abbreviated as WL4W, offers survivors a specialized program to implement evidence based guidelines encouraged by experts.

The group was developed and is implemented by Deborah Kronenberger MA, LCPC, a Licensed Clinical Counselor with a specialty in mindfulness, and Lori Bumbaco RD, a Board Certified Specialist in Oncology Nutrition. The group is closely aligned and partners with Carolyn Kirschner MD, a Gynecologic Oncologist who now specializes in survivorship.

Emerging Themes
Since its inception, several principles have emerged in the evolution of the WL4W. The program is unique in its comprehensive approach, which embraces:

1. Mindfulness:
WL4W is a mindfulness based program. Members learn how to adopt skills to practice mindfulness to address emotional distress, healthy eating choices, and peacefulness in their lives.
2. Progress, not perfection:
The program maintains an important mantra while recommending healthy lifestyle guidelines. Members are empowered to make healthier decisions, rather than to expect perfection in their choices.
3. Patience:
While weight loss is promoted in the program, from the beginning the group is encouraged to shift focus away from the scale and move towards healthy behaviors. Modifying lifestyle will ultimately lead to emotional and physical health.
4. Tracking:
Keeping track of food choices and physical activity is a way to practice mindfulness. Members that consistently track learn about their personal habits, permitting them to decide which habit they are most motivated and confident to improve.
5. Resiliency:
When a lapse in judgment occurs, the most important next step to take is to recover. During this process, there is an opportunity to learn about oneself. The next time we confront that situation, we can pay attention without judgment and move forward.

Early Success
Within a matter of only two years, members of WL4W have realized significant improvements in their wellness. We are proud to acknowledge that the majority of its graduates loss an average of 9.3 pounds, ranging up to 35 pounds. An impressive 34.9% of the graduates have lost at least 5% of their body weight. Surveys have shown that scores rating wellness have improved for those who have lost weight. Graduates have even reported significant improvement in diabetes and resolution of fatty liver. The comprehensive approach and integrated partnership between Debby and Lori embraces the opportunity to provide its participants with significant and powerful ways to achieve their pursuit of wellness.

1. Rock CL et al. (2012). Nutrition and Physical Activity Guidelines for Cancer Survivors. CA Cancer J Clin;62:242-274.
2. Institute of Medicine. Implementing Cancer Survivorship Care Planning. Washington, DC: National Academies Press; 2007.
3. Demark-Wahnefried W, et al. (2015). CA Cancer J Clin;65:167-189.

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