Cancer-related changes in body weight are problematic given that excess weight is associated with an increased risk of cancer reoccurrence and mortality. The purpose of this qualitative study was to explore the experiences of weight-concerned women treated for early-stage breast cancer. A purposeful sample of women were selected based on criteria for high weight and body image concerns (n = 11; Mage = 65.31 ± 10.96 years). Each participant engaged in a one-on-one semi-structured interview. Five themes were identified: weight concerns contributed to psychological distress, prevalent history of weight cycling and ongoing quest to manage weight, shifting psychological impact of cancer versus weight, perceptions of failure around goal-oriented weight management behaviors, and internalized and explicit social pressures for weight loss in the context of risk reduction. In light of the fundamental challenges of weight management, and the present findings, improving weight-related distress should be a clinical priority to improve the well-being of women in survivorship.