A new study from the US found that moderate weight reduction helped to reduce urinary incontinence among overweight and obese women.

The research was the work of first author of Dr Leslee Subak from the University of California, San Francisco (UCSF), and colleagues, and is published online in the 29 January issue of the New England Journal of Medicine. Subak is an obstetrician/gynecologist at the Women’s Continence Center in the UCSF Women’s Health Centre.

In their background information the authors wrote that obesity was already known to be a risk factor for urinary incontinence, but there wasn’t enough evidence on whether losing weight could help obese women with incontinence.

For the study, Subak and colleagues randomly assigned 338 overweight and obese women diagnosed with urinary incontinence to one of two groups. Most of the women were aged between 40 and 65 (average age was 53) and all were experiencing at least 10 urinary incontinence episodes a week before the study.

One group (226 patients) went through an intensive 6 month weight-loss program comprising diet, exercise, and other lifestyle changes, while the other group (112 patients) just went to structured education classes that told them about the benefits of weight loss (the controls).

The results showed that:

  • At the start of the intervention period, the BMI (body mass index, the weight in kilos divided by the square of the height in metres) and the weekly number of incontinence episodes were similar in both groups.

  • After 6 months, the women in the intensive weight loss group had a mean weight loss of 8 per cent (7.8 kg) compared with 1.6 per cent (1.5 kg) in the education only group (the controls).

  • The mean weekly number of incontinence episodes went down by 47 per cent in the intensive weight loss group, compared with only 28 per cent in the control group.

  • Compared with the control group, the intensive weight loss group had no more significant numbers of urge-incontinence episodes a week, but they had significantly fewer of the stress-incontinence type.

  • A higher proportion of the women in the weight loss group had a clinically relevant drop of 70 per cent in overall frequency of all-, stress-, and urge-incontinence episodes.

Subak and colleagues concluded that:

“A 6-month behavioral intervention targeting weight loss reduced the frequency of self-reported urinary-incontinence episodes among overweight and obese women as compared with a control group.”

Reduction in urinary incontinence may now count as one more of the many health improvements that moderate weight reduction can bring to women who are overweight, they added.

“Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women.”
Leslee L. Subak, M.D., Rena Wing, Ph.D., Delia Smith West, Ph.D., Frank Franklin, M.D., Ph.D., Eric Vittinghoff, Ph.D., Jennifer M. Creasman, M.S.P.H., Holly E. Richter, Ph.D., M.D., Deborah Myers, M.D., Kathryn L. Burgio, Ph.D., Amy A. Gorin, Ph.D., Judith Macer, B.Sc., John W. Kusek, Ph.D., Deborah Grady, M.D., M.P.H., for the PRIDE Investigators.
Volume 360, Number 5, 481-490, January 29, 2009.

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Sources: Journal Abstract.

Written by: Catharine Paddock, PhD