Integrated Weight Management as a Key Factor for Enhancing Outcomes in Fertility-Sparing Endometrial Cancer Treatment



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Endometrial cancer (EC) is closely associated with obesity and metabolic disturbances involving glucose and lipid metabolism. Modern approaches to conservative therapy in young women with EC aim at preserving fertility and often include high-dose progestin therapy, which can exacerbate weight gain. The relationship between obesity and EC treatment efficacy is complex, involving hormonal alterations, chronic inflammation, metabolic disruptions, and changes in tumor immune microenvironment. A comprehensive approach to weight correction—including dietary interventions (ketogenic diet, intermittent fasting, calorie restriction), regular physical activity, and behavioral therapy—has significantly improved tumor remission rates and pregnancy outcomes. This review discusses key mechanisms linking obesity to EC progression, examines contemporary strategies for weight management, and outlines future research directions, such as exploring metabolite roles, gut microbiome impact, neuronal appetite-regulation mechanisms, and personalized interventions utilizing artificial intelligence and wearable technologies. Integrated weight management emerges as a priority for enhancing treatment efficacy and fertility outcomes among EC patients aiming to maintain reproductive potential.

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