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Lose a Little Weight, Gain Some Continence

Weight loss between 5% and 10% of body weight was associated with significantly improved urinary incontinence in overweight and obese women.

Obesity is a known risk factor for urinary incontinence. Weight loss improves urinary incontinence, but just how much weight loss is needed? Investigators analyzed data from the PRIDE (Program to Reduce Incontinence by Diet and Exercise) clinical trial, in which 338 overweight or obese women (mean age, 53) with urinary incontinence were randomized to an 18-month behavioral weight loss program or to a structured education program.

All participants were grouped into weight-loss categories (gained weight, lost 0% to <5%, lost 5% to <10%, or lost 10% of their baseline body weight). Compared with women who gained weight, those who lost 5% to <10% of their body weight were significantly more likely to experience 70% reductions in incidence of total urinary incontinence episodes, regardless of initial weight or severity of incontinence (odds ratios, 3.7 at 12 months; 2.4 at 18 months). Improvement was similar for women who lost 10% of their body weight. About 75% of women who lost either 5% to <10% or 10% of their baseline body weight were very satisfied or moderately satisfied with their overall changes in leakage at 6, 12, and 18 months.

Comment: Weight loss of 5% to 10% of body weight lowers risk for diabetes and hypertension. Here, the same degree of weight loss (i.e., 4.5–9.0 kg [9.9–19.8 lb]) was associated with significant clinical improvement in urinary incontinence. Women would benefit from weight loss as the initial approach to managing urinary incontinence. This provides clinicians with yet another compelling reason to encourage participation in structured or behavioral-based weight loss programs (JW Womens Health Aug 19 2010).

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health August 26, 2010

Citation(s):

Wing RR et al. Improving urinary incontinence in overweight and obese women through modest weight loss. Obstet Gynecol 2010 Aug; 116:284.

• Medline abstract (Free)

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