Posted on February 24, 2009
Weight loss reduced frequency of urinary incontinence
In addition to prevention of diabetes, decreased urinary incontinence may be an additional benefit of weight loss.
Behavioral intervention targeting weight loss reduced
self-reported urinary incontinence episodes in overweight and obese women
compared with a structured education program.
The researchers randomly assigned overweight and obese
women with at least 10 urinary-incontinence episodes per week to either a
six-month weight-loss program including diet, exercise and behavior
modification (n=226), or to a structured education program (n=112). The mean
age of participants was 53 years.
The mean weight loss was 8% in the intervention group
compared with 1.6% in the control group (P<.001). The mean weekly
number of episodes decreased by 47% in the intervention group vs. the control
group (28%; P=.01). The intervention group had a greater reduction in
frequency of stress-incontinence episodes (P=.02) but not of
urge-incontinence episodes (P=.14) as compared with the control group.
A higher proportion of the intervention group had a
reduction of ≥70% in frequency of all incontinence episodes
(P<.001), stress-incontinence episodes (P=.009) and
urge-incontinence episodes (P=.04) vs. the control group, according to
the study.
“A decrease in urinary incontinence is another
health benefit associated with weight loss, and that weight reduction can be a
first-line treatment in overweight and obese women,” Leslee L. Subak,
MD, obstetrician/gynecologist at the University of California, San
Francisco, said in a press release. – by Christen Haigh
N Engl J Med. 2009;360:481-490.
The majority of previous studies that found decreases in urinary
incontinence with weight loss focused on effects of large decreases in weight
after bariatric surgery. The recent randomized study by Subak and colleagues is
a significant addition to the literature because it indicates that even
moderate weight loss, achievable with modifications in diet, exercise and
behavior, can result in significant improvement in urinary incontinence in
overweight and obese women. Importantly for clinicians, the investigators
observed benefits of weight loss for stress, urge and mixed incontinence,
suggesting that a weight loss program may be an initial strategy for many of
their overweight and obese female patients with urinary incontinence.
– Mary K. Townsend, ScD
Yerby Research Fellow, Department of Epidemiology
Harvard School of Public Health, Boston
