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Honor Your Body

Coming to terms with feelings and emotions about weight gain and weight loss is often part of a cancer patient's experience. By Sue Rochman

When Laura Walker was diagnosed with breast cancer in October 2012, how much she weighed was the furthest thing from her mind. She was more concerned about the side effects of chemotherapy, surgery and radiation. Then, a year after her mastectomy, Walker, a mother of four from West Columbia, Texas, went to see a plastic surgeon at the University of Texas M. D. Anderson Cancer Center in Houston to discuss her breast reconstruction. The surgeon didn’t ask Walker to undress or take a look at her scar. “Just looking at me, she knew I was too big,” she says.

Body Acceptance
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It was January 2014. Walker was 41 years old and weighed 328 pounds. Her body mass index (BMI) was 53. She had been overweight for more than a decade. To have surgery, she learned, her BMI would have to be 35 or less. “I didn’t even know what BMI was,” says Walker. “I was just living my life. I was happy. I gave no thought to what I was eating or what I weighed.” That would need to change. Her body was carrying a 100-pound obstacle that stood between her and a new right breast.
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Hair loss, losing a breast, disfiguring facial surgery: These are all readily acknowledged ways in which cancer and its treatments can affect a patient’s sense of self. Weight often doesn’t make the list. Yet weight, body image and cancer are closely connected. Some patients may find cancer treatments cause unwanted weight gain. For others, stressful eating in the face of cancer can put on pounds that keep a favorite dress from zipping up or make a suit uncomfortably tight. Still others may be advised to lose weight to reduce their risk of recurrence or, like Walker, told they must lose weight to undergo reconstructive surgery. 
In some ways, body image can be considered a 
pre-existing condition. “Some people may already come into cancer feeling self-conscious about their bodies,” says Michelle Fingeret, a clinical psychologist who runs the Body Image Research and Therapy Program at M. D. Anderson Cancer Center. “We want people to understand that whatever relationship you had with your body before cancer—if that relationship was not so healthy to begin with or if you didn’t have body image problems to begin with—you can learn to process your experience and find ways to honor and appreciate your body.”

It’s Not Vanity
Kim Barker’s self-image took a hit in July 2014 when she was put on a high-dose steroid to counteract brain swelling, a side effect of an immunotherapy drug she was taking in a clinical trial for her stage IIIC melanoma. Barker, now 45, had been slim and fit when she was diagnosed in October 2012. Stress stemming from her diagnosis and initial treatments had caused her to drop to 98 pounds from her pre-cancer weight of 110. Within days of starting the steroids, however, her weight ballooned to 122 pounds. The person she saw in the mirror didn’t look anything like who she thought herself to be.

“I was always petite,” says Barker, a speech pathologist in New Smyrna Beach, Florida. “Now, none of my pants fit, none of my shorts fit. I found myself wearing flouncy types of shirts that aren’t fitted and definitely not dressing up. I used to get up, take a shower, do my hair, put some makeup on so I looked nice, and that stopped completely. I pretty much wore the same thing all the time.”

Compounding the weight gain was the exhaustion, another side effect of the immunotherapy. Then one day, Barker’s now 7-year-old daughter asked her, “How come you don’t do your hair anymore?” That, says Barker, “was a real eye-opener. I had this physical shift plus an emotional shift from a lack of physical activity, and when your kids can notice it, that says something.”

Barker says it was hard to not think that others might view her as someone who didn’t eat well or work out. Even harder was the idea of talking about it. “I didn’t want anybody’s negative input. You wonder if someone would view you as being really vain, and be thinking, ‘Well, you are alive.’ And I sometimes feel that myself: What difference does it make if you don’t fit into those clothes? At least you are here.”


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