Patient description: The patient is a 47-year-old Asian woman complaining of persistent feelings of sadness. She lost interest in activities she used to enjoy. She states that her mood is mostly depressed for the past 3 weeks. She also lost her appetite , which led to about 5kg weight loss. She complains of loss of energy and feelings of worthlessness nearly every day. She is not using any drugs and she does not smoke. She doesn't drink alcohol. She used to exercise every day for at least 30 min. But she doesn't have enough energy to do so for the past 3 weeks. She also has some digestive issues recently. She is married and has 4 children. She is menopausal. Her husband was recently diagnosed with colon cancer and he is starting his chemotherapy. There is nothing remarkable in her past medical history and her drug history is only positive for Vit D3 1000 units daily. Her family history is negative for any psychologic problems. Her HAM-D score is 20.

Clinical trial eligibility criteria: eligible ages (years): 18.0-45.0,  Overweight Breast Cancer Obesity Female sex Age: 18 years, since older age may impact appetite regulation45-47 and women >45 are more likely to have begun the menopausal transition (estrogen relates to appetite and eating behavior) Body mass index [BMI]: 25 kg/m2. Since body composition and body mass relate to appetite regulation and energy intake, a narrow BMI range should decrease heterogeneity within the results. The BMI range was chosen to represent a population at risk for developing obesity and associated comorbidities, while also excluding individuals with severe obesity (which may plausibly significantly impact energy intake regulation) Pre-menopausal before cancer diagnosis and treatment <1 hour/week of planned physical activity by self-report in the previous 12 months, since exercise may alter appetite and response to food Diagnosis of primary stage I II estrogen receptor/progesterone receptor-positive (ER/PR+) breast cancer, according to institutional standards All chemotherapy, radiation, and surgery completed at least two weeks (14 days), but less than 6 months prior to registration  Cancer diagnosis in the last 5 years before breast cancer; any site, excluding melanoma History of cardiovascular disease or symptoms suggestive of cardiovascular disease: chest pain, shortness of breath at rest or with mild exertion, syncope Diabetes mellitus, uncontrolled hypertension (defined as: systolic blood pressure >160 mmHg or diastolic blood pressure >100mmHg, as measured during the screening visit with participants seated quietly), untreated/uncontrolled thyroid disease, or any other medical condition affecting weight or energy metabolism. Participants who are deemed ineligible based upon uncontrolled hypertension will be referred to their primary care physicians for treatment. If this condition become controlled they will be allowed to be re-evaluated for in the current trial Unable to exercise due to cardiac, pulmonary, neurological, orthopedic reasons Currently smoking and/or nicotine use Treatment with medications known to significantly affect appetite, weight, energy metabolism, EI or energy expenditure in the last 3 months (e.g. appetite suppressants, lithium, stimulants, anti-psychotics, tricyclic antidepressants) Corticosteroid use within the last two weeks History of surgical procedure for weight loss at any time (e.g. gastroplasty, gastric bypass, gastrectomy or partial gastrectomy, adjustable banding, gastric sleeve); history of extensive bowel resection for other reasons Currently pregnant, lactating or less than 6 months post-partum Score of ≥ 2 on the CAGE (cut-annoyed-guilty-eye opener) questionnaire adapted to drug use