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Losing Weight Improves Incontinence Symptoms

Participation in a supervised weight-loss program was associated with subsiding urinary incontinence episodes in overweight and obese women.

Obesity correlates with both stress and urge urinary incontinence; therefore, weight loss would seem — but is not proven — to be an effective treatment. In a behavioral intervention study, investigators randomized 338 overweight and obese women (19% black; mean age, 53; mean baseline BMI, 36 kg/m²) to an intensive 6-month weight-loss program (weekly professionally led group sessions about reduced-calorie diets, behavioral changes, and exercise implementation) or an educational program (4 sessions that provided general information about weight loss, exercise, and healthful eating). All participants received self-help bladder-control booklets and completed 7-day voiding diaries at baseline and at follow-up.

At baseline, all women reported experiencing 10 urinary incontinence episodes weekly. At 6 months, women in the weight-loss group achieved greater weight reduction than did those in the control group (mean loss, 8.0% vs. 1.6% of baseline weight; P<0.001). Number of weekly incontinence episodes decreased by 47% and 28% from baseline for any incontinence (P=0.01) and by 58% and 33% for stress incontinence (P=0.02) in the weight-loss and control groups, respectively. Overall, 41% of the weight-loss group and 22% of the control group experienced 70% fewer weekly incontinence episodes (P<0.001). At the study’s conclusion, women in the weight-loss group were substantially more satisfied with their urinary continence than were those in the control group.

Comment: Incontinence symptoms diminished in both groups, probably because all participants adopted some of the techniques in the educational materials; nonetheless, reducing incontinence seems to be an additional benefit of weight loss in overweight or obese incontinent women. Weight loss and maintenance can be highly challenging, so clinicians should identify appropriate local or online resources to which they can refer patients for additional support.

— Diane E. Judge, APN/CNP

Published in Journal Watch Women's Health January 28, 2009

Citation(s):

Subak LL et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 2009 Jan 29; 360:481.

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