Weight Loss Helps Incontinence

By Margarita Nahapetyan

Overweight patients are often advised by medical professionals to lose weight in order to better fight certain conditions, such as heart disease, type 2 diabetes, and cancer. There is a strong evidence that excess weight leads to these problems, as well as prevents patients from getting better and recovering.

A recent new study showed another reason why obese people, especially women, should start losing weight. According to researchers from University of Arkansas for Medical Sciences, weight loss and changes in a lifestyle may improve the symptoms of urinary incontinence for women in a very efficient way.

Urinary incontinence (UI) is an involuntary leakage of urine. The condition can range from a small amount of urine leaking to having very strong urges to urinate that are very hard to control. It is a common and distressing problem, which may have a profound impact on a quality of life. Urinary incontinence almost always results from an underlying treatable medical condition. Common causes of temporary urinary incontinence are recent childbirth, side effects from some medications, limited mobility or urinary tract infection. Millions of people in the United States are suffering from this condition, which can also affect younger people, especially women who have just given birth to a child.

For their study, called the Program to Reduce Incontinence by Diet and Exercise (PRIDE), the researchers examined 338 overweight or obese women 42 to 64 years of age, who had 10 or more weekly episodes of incontinence. All the participants were divided into 2 groups: 226 women were assigned to a weight loss intervention group, and 112 women were assigned to a control group. Women in both groups were given a booklet with information about exercises for incontinence and how to control urinary urgency.

The control group took part in four monthly education programs where they received information about how to lose weight, how to exercise and about a diet. The intervention group participants were meeting every week for a six months period, and learned about nutrition, exercise and behavior modification. They were also offered a regular calorie-reduction diet of 1,200 to 1,500 calories per day, plus meal plans. In addition to all that, all women were asked to gradually increase their exercising, such as brisk walking, until 200 minutes of weekly activity has been reached.

At the end of the study, six month later, the intervention group was found to lose an average of 8 per cent of their body weight (approximately 17 pounds), and the weekly urinary incontinence episodes in this group were cut by more than 47 per cent. As to the second group, the women there lost an average of 1.6 per cent of their body weight and had only 28 per cent fewer episodes on incontinence. The intervention group also experienced fewer stress incontinence episodes, such as losing urine uncontrollably due to coughing, sneezing or exercise. However, there was very little difference between the two groups in a strong, sudden urge to urinate.

The results support the inclusion of weight reduction as a first-line treatment for incontinence for overweight and obese women, according to Leslee L. Subak, MD, a lead author of the study and an associate professor in the obstetrics, gynecology and reproductive sciences; urology, and epidemiology and biostatistics departments at UCSF.

"It has been well documented that behavioral weight-loss interventions decrease the risk of developing type 2 diabetes and high blood pressure, improve control of high blood pressure and cholesterol levels, and improve mood and quality of life," she explained. "Our results suggest that a decrease in urinary incontinence can now be added to the extensive list of health benefits associated with weight loss."

Previous studies have shown that obesity is a dangerous and a very strong risk factor for urinary incontinence, a condition that affects more than 13 million women in the United States and accounts for about $20 billion in health care costs every year, Leslee Subak added. The main goal for the PRIDE research team was to provide evidence of the beneficial effect of a weight loss program, which included diet and exercise on urinary incontinence. The research team plans now to examine additional data to find out whether the effect of weight loss can be maintained over a period of 18 months.

Other investigators and co-authors of the study were Deborah Grady, MD, MPH, of UCSF and the San Francisco Veterans Affairs Medical Center; Rena Wing, PhD, Miriam Hospital and Brown University; Delia Smith West, PhD, University of Arkansas; and Frank Franklin, MD, PhD, University of Alabama in Birmingham.

The study was published in the New England Journal of Medicine. It was funded by the Office of Research on Women's Health (ORWH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), jointly.