BETA - What healthy weight loss plans are recommended? Is is safe to diet during active cancer treatment? Is surgery an option?

What healthy weight loss plans are recommended? For people who lose weight, they need to do it in a very stepwise balanced fashion, especially while on treatment because you don't want to suddenly restrict completely not eating or things because you're going through treatment, which is also a complexity in the health and overall well-being. In terms of healthy weight loss, there are different ways that people approach this. What we have shown in our studies is eating more fiber leads to less calories consumed in terms of just because fiber rich foods are usually calorie low foods because they are, and fiber is satiating. So for the same, like to feel the same level of fullness or satiety, you would just eat less calories if you are eating a fiber rich diet. And so that's why even though we have patients on our study eat to satiety, they're just eating less than they typically would and that helps them come to a normal weight just gradually. Other studies have looked at fasting or time restricted eating and it's considered healthy to eat within a certain window. And I think if we think about it from the point of our own biologic clocks, it's important to eat within the daytime in a short period than to be snacking all throughout the night or late night because our body doesn't handle it the same way as when we are more active. And so thinking about a window of maybe 12 hours or less, maybe 10 or 8 hours where you're eating and then having the rest of the time to have the gut rest, it can be healthy too. But I think every patient needs to individualize it to what works for them because completely restricting eating where then you are craving food or really suffering and very hungry the next morning and then just eating anything that you get your hands on because you're so hungry, then that is also not going to be as healthy. So it's important that the diet quality matters too, not just the timing of the food as well. There is evidence to suggest myeloma is one of the 13 cancers that have been officially classified as obesity related cancers and myeloma is one of them. And there is evidence to suggest that obese individuals are more likely to develop MGUS and the ones that have MGUS are at least twice as likely to transform into multiple myeloma from MGUS. And patients who have been diagnosed with myeloma, who are obese, actually have worse outcomes with myeloma. So it is shown to affect at every stage of myeloma or even the precursor stages. So definitely, I think starting to make these small changes in your diet early on in life when we were kids or so is actually recommended to basically never get in the range of overweight or obesity. So maintaining weight in the normal range throughout your life has been shown to be very important both to prevent cancer and if at all you do develop cancer to improve outcomes. Weight cycling is actually shown to be detrimental in some studies and so not going the up and down route and just kind of trying to maintain your weight in a normal range throughout life, I think that's shown to be the healthiest approach. And using diet, I think, as a way to achieve weight loss, so high fiber diet, plant-based diets, these interventions to achieve weight loss are considered optimal or healthier than other types of like or other strategies. So Dr. Shah's team had actually looked at ketogenic diets versus plant-based diet and found that plant-based diet was actually superior to improving outcomes as compared to ketogenic diets. So I think incorporating a diet that is rich in high fiber fruits, vegetables, legumes, whole grains, minimally processed foods, minimal red meat, I think those strategies to adopt for targeting weight loss or achieving weight loss I think would be healthy and indicated or recommended by the guidelines. Is it safe to diet during active cancer treatment? There's been lots on social media about the carnivore diet and people thinking that they need to eat more protein and more protein and just not thinking about the other health promoting foods. I think that that can be very dangerous for patients because then they're not getting enough of the vitamins and nutrients and minerals and they can actually develop deficiencies as well. It's also much harder on the overall body and kidneys and everything too. So I would say that there can be many different weight loss or dietary plans and you can look at what works for you, but in general a few principles or guiding things that are important when you think about a plan is one that is prioritizing eating whole unprocessed foods and looking at enough fiber in the diet because I think that if you're getting enough of that, that's going to help with healthy gradual weight loss as well.