My diagnosis of breast cancer was not the hardest part. Far more difficult to cope with were the preceding two weeks, after the radiologist suggested the dark patch she could see on the ultrasound was ‘worrying’ and needed a biopsy.My heart did a cold plunge to the floor. What kind of ‘worrying’, I wondered, as I scrutinised her poker face for clues.As any of the one in seven women who receive a breast cancer diagnosis will testify, ‘worrying’ (see also ‘concerning’ or ‘suspicious’) covers a wide spectrum of outcomes.During the fortnight between my biopsy and the in-person results, that single word haunted my nights and obsessed my days. My gut instinct told me this was cancer, and I fell down a dark Google rabbit-hole of grades and stages and how it really wouldn’t suit me to lose my big, curly hair to chemotherapy. At 1am, I lay awake stressing about rare genetic mutations. Even Chat GPT started to tell me to get off Chat GPT and enjoy the summer.In the end, my gut was right: the surgeon told me I did, indeed, have an invasive tumour in my left breast. But because it had been caught early on a routine mammogram screening – I hadn’t once felt a lump – it was small. The cancer was low-grade, hormone-positive and had not spread to my lymph nodes. My fear turned to relief and a sense of resolve: I would get over it.As I write, I am recovering from a lumpectomy and waiting to see an oncologist to arrange a short course of radiotherapy. Chemo is mercifully not on the cards. The prognosis is optimistic. After being told a dark patch on her ultrasound looked 'worrying', Miranda Levy started worrying about her health and the possibility of cancerBut once I knew I was out of the woods, I began to ask a question: why did I, at 58, get breast cancer in the first place? Was it something I had done?I was fit and healthy at the time of diagnosis, but I weighed too much. At about 11st 3lb and 5ft 2in, my BMI was 28.7, and firmly in the overweight category. In fact, because the pounds were stubbornly refusing to shift, a few months before, I’d started to use the weight-loss drug, Mounjaro. (At my first surgical appointment, I told the consultant I was on the jab. ‘Good!’ he said. ‘We encourage you to keep using it.’)And, yes, being overweight undoubtedly raises your risk of breast cancer, especially in post-menopausal women. Was it a cause of mine?‘When it comes to breast cancer, there are two types of risk – fixed and modifiable,’ says Mr Naren Basu, a consultant breast and oncoplastic surgeon, and associate professor at the University of Birmingham. ‘Fixed risks include ageing – 80 per cent of breast cancers are in women over 50. Then there is your genetic make-up and family history.‘But weight is really important. Fat cells produce a state of chronic low-grade inflammation, resulting in cellular processes that can promote tumour growth and spread. Excess fat causes a state of insulin resistance and can lead to hormonal changes including excess oestrogen production.’Weight gain during perimenopause, carried over to the menopause, is particularly detrimental, he adds. Miranda began to wonder if her weight had contributed to her cancer diagnosis (seen in 2020)I began to wonder just how damaging my weight had been. If I’d started Mounjaro earlier, would I have even got cancer in the first place?My size had only become a problem in the past ten years. Until my mid-40s, I’d never weighed more than 7st 11lb and was a slim and sporty size 8 to 10. I spent the 1990s and 2000s working as a women’s magazine journalist, tottering about in designer clothes and Chloe heels.But in 2010, when I was 42 and the mother of two primary school-age children, my life imploded. My husband told me he wanted to end our marriage, and I was plunged into a whirl of insomnia, anxiety and depression which eventually became so severe I lost my job and had to go back to live with my father in Essex.In their attempts to treat me, doctors put me on a dizzying array of psychiatric drugs which included various antidepressants such as venlafaxine and mirtazapine, tranquillisers, and even – at one point – an antipsychotic called olanzapine, which they said would ‘augment’ the antidepressants. It didn’t.None of these pills made me feel better: in fact, they made me feel worse, muddle-headed and agitated. I also started to put on an enormous amount of weight.The pills made me crave carbohydrates: I remember once ripping open a packet of Scottish shortbread biscuits, devouring four, going halfway up the stairs, then saying: oh, what the hell, and going back down again to finish the pack.This is one of the reasons why this week’s news that a record one in seven people in England are on antidepressants should alarm us all. The vast majority of prescriptions are for SSRIs (selective serotonin reuptake inhibitors) with those for sertraline increasing by 120 per cent over the past decade.I personally was unable to tolerate SSRIs – they made me feel sick and shaky – so I only ever took them for a few days. But for most people, SSRIs are the ‘first line’ antidepressant treatment, and 18 per cent of people experience significant weight gain on them. I spent the 1990s and 2000s working as a women’s magazine journalist, tottering about in designer clothes and Chloe heels, says Miranda (seen in 1999)Either way, I am absolutely testament to the fact that in ‘fixing’ people’s mental health, we may be damaging them in other ways.My drugs certainly didn’t help my physical health. Dinner back then was ready meals. I stopped exercising: in fact, I only left the house to go to medical appointments.Instead, I sat in the bedroom at my Dad’s house in my pyjamas watching box sets on an iPad, while eating endless rounds of toast and jam. Those designer clothes and Chloe heels sat in the wardrobe, ghosts of a former life.At that point, I didn’t care about my appearance. I had lost my career, friends and even – briefly –my relationship with my children, who lived full time with their father.My weight was, quite frankly, the least of my problems. My stomach eventually became so big I struggled to see over it to put my socks on, but it didn’t cross my mind to get on the scales.At the start of my illness, I lost weight through stress. But from 2016, when the mirtazapine and olanzapine were added, I started to pile it on at an enormous rate.Finally, in 2019, over a period of six months, I re-entered the world. I reconnected with my family and made attempts to kick-start my career again. And I started to become aware of my size.That spring I recall a check-up appointment with the nurse at my GP practice, which involved being weighed. I looked down at the scales and to my shock saw I was almost 15 st.Though I didn’t look it up at the time, my BMI was more than 38 – seriously obese. The nurse was kind, but I sensed there was something she wanted to say. There was an elephant in the room, and the elephant was me.I remember going to a High Street store to pick up some cheap and cheerful clothes one day, and realising I could fit into nothing less than a size 20. My God, I had literally doubled in size. The only things I could wear had old-lady elasticated waist-bands and looked like shapeless sacks.But it wasn’t just my appearance that was suffering, so was my health. I was unable to walk round the block without having to stop three times to catch my breath. Blood tests showed my LDL ‘bad’ cholesterol and my blood sugar were starting to climb.Looking back, I wonder whether the extra oestrogen produced by my fat cells was making my body more susceptible to the cancer diagnosis I would receive six years later.Knowing I was now in control, I started to reduce the drugs. Some of these pills came with hideous withdrawal symptoms such as insomnia (ironically) and nausea.Ten years on, I am still on tiny doses of a couple of these – though not the worst weight-gain culprits mirtazapine and olanzapine – as I continue to ‘taper’ them and reduce my suffering as much as possible.At the same time, I stopped eating ready meals and toast and started cooking with fresh ingredients again. My father had a treadmill at home: I walked on it for 20 minutes at a time while watching comedy shows on TV.When moving around became easier, I hired a personal trainer. At first, we went for slow walks, then faster ones, before graduating to running, boxing and basic resistance training. The first two stones fell off in three months.During this period, I finalised my divorce and bought a flat, too. At first via social media and later in joyful person, I met a new man, Jeremy, a comedy writer from New York. At that point, I was still a size 16 to 18 and self-conscious about it – but Jeremyhad also struggled with his weight in the past and didn’t care about my dress size. We fell in love and have just celebrated our first wedding anniversary.Despite my newfound happiness, my weight still bothered me. Now in my mid-50s, I made the best of my figure with flatteringly cut clothes in dark shades, but I still didn’t look like ‘Miranda’.I hit a wall at 12st 3lb, and whatever I did, the scales did not seem to budge. Every now and then, I’d catch sight of myself in a shop window and think: who’s that?Meanwhile, everyone was talking about Ozempic and the other weight-loss drugs just coming to market. In fact, I tried Mounjaro for the first time in autumn 2024, very shortly after it was licensed for weight loss in the UK, but the in-person clinic I visited said they’d run out of the 2.5mg ‘starter dose’ and put me on three times that from the word go. I was sick and constipated for a week.I couldn’t eat, sure, but that was because I felt so utterly dreadful – and I vowed never to do it again. But in April this year, still unable to bust the 12st barrier, I gave in and tried again, this time with a reputable online pharmacy, MedExpress. By the end of May, I had lost a stone.By the middle of June, I had a breast cancer diagnosis.Was I just too late to start tackling my midlife weight problem?Cancer UK says quite explicitly that obesity is linked to 13 different kinds of cancer, with a direct correlation between risk and the length of time you’ve been overweight.One major study pooling large amounts of data also suggested that sustained weight loss was associated with lower breast cancer risk among the over-50s.Should I ‘blame’ myself for getting cancer?I ask the expert Mr Basu. ‘No,’ he says. ‘To anyone asking why they get breast cancer, I’d say it was down to bad luck. In many cases we don’t know why it has happened to them.‘Cancer is a genetic problem and a problem of ageing. But the good news is that you can always reduce your own risk of getting cancer in the first place, as well as the risk of recurrence, by managing your modifiable risks.’He also mentions that having children later can increase your risk (I had mine at 34 and 36), as can drinking any alcohol at all. ‘Alcohol increases your breast cancer risk by changing your hormone levels and damaging your DNA,’ he says.Until recently, I’d definitely been flying close to the NHS 14-units-a-week booze limit. Now I’m on Mounjaro, I drink a lot less – another intriguing side effect of the drug.But weight is also an undeniable factor and, in a nutshell, losing it – however you manage to do it – is a good thing for your health.I will continue to exercise, eat healthily and use Mounjaro. At the time of writing, I’m down to around 10st 7lb, and a size 12 to 14. I’m lucky that I only really had the ‘small c’ – caught early and dealt with swiftly.No one wants a cancer diagnosis, but I’m a different person than I was at the end of my marriage in 2010.I’m looking forward to the future with confidence. Nothing will make me go back on antidepressants again. For me, psychiatric drugs created far more problems than they solved.And maybe, by continuing to lose weight and keep it off, which I absolutely intend to do, I can also stop my cancer coming back.For support or information on breast cancer speak to Breast Cancer Now’s expert nurses by calling their free, confidential helpline on 0808 800 6000 or by visiting breastcancernow.org