Urinary Incontinence Treatment? Weight Loss, Study Shows

Obesity is widely known to increase a person's risk for health problems such as diabetes, high blood pressure, and high cholesterol levels, but many don't realize that obesity is also a strong risk factor for urinary incontinence (UI). And just as obesity rates are higher than many realize – more than one-third of U.S. adults are obese – the prevalence of urinary incontinence is often underestimated.

Despite the lack of attention the health problem seems to receive, more than 13 million U.S. women suffer from urinary incontinence and estimates show that it is responsible for approximately $20 billion in heath care costs each year. Women across the United States are searching for a treatment for urinary incontinence, and weight loss may be the answer for some of them. According to recent studies led by Dr. Leslee L. Subak, associate professor at University of California San Francisco, weight loss shows significant promise as a treatment for urinary incontinence among obese women.

5%-10% weight loss results in up to 71% reduction in Urinary Incontinence episodes

A 2005 report by Dr. Subak and colleagues presented the results of a randomized, controlled clinical trial looking at overweight and obese women with UI (an average of 21 UI episodes per week). Women were placed in one of two groups: an immediate intervention group that began a 3-month liquid diet at the start of the study, and a delayed intervention control group that didn't begin the weight reduction program until month 3 of the study.

Three months after the study began, women in the immediate intervention group had lost an average of 16 kg and experienced a 60% reduction in weekly UI episodes. They had improved quality of life scores, and decreased episodes of both stress incontinence (involuntary urine loss with coughing, sneezing, straining, or exercise) and urge incontinence (loss of urine associated with a strong urge to void).

Women in the control group, who had not yet begun the weight loss program and had maintained their starting weight, had only a 15% reduction in UI episodes. However, after participating in the weight loss program, the control group experienced a comparable decrease in weekly UI episodes – 71%. Weekly UI episodes across both groups decreased by an average of 54%, and the reduction in episodes was still seen after 6 months.

Weight loss particularly helpful for stress incontinence

Dr. Subak and colleagues at several universities recently conducted another study, the results of which were reported in the January 29, 2009 issue of the New England Journal of Medicine. In this study, 338 overweight and obese women were randomly assigned to either a 6-month weight loss program consisting of diet, exercise, and behavior modification, or to a weight loss education program that provided no additional guidance (the control group).

Women in the intensive program lost an average of 8% of their body weight (around 17 pounds) and decreased their number of UI episodes by 47%. Those assigned to the information-only group had an average weight loss of only 1.6% (3 pounds), and a 28% reduction in UI episodes. When the two groups were compared, it was found that the intervention group benefited from a decrease in stress incontinence, but did not show a significant difference from the control group in terms of urge incontinence. In general, more women in the intervention group reduced their number of total UI episodes per week by at least 70%, a clinically significant reduction. When asked after 6 months, women in the intervention group reported a greater improvement in their incontinence as well as higher satisfaction in the outcome.

As the research shows, urinary incontinence is yet another health concern that can be greatly improved with the loss of even a moderate amount of weight. Women in the previously mentioned studies lost only around 5%-10% of their body weight, but still saw a significant improvement in frequency of UI episodes per week. Weight loss appears to be as effective as other nonsurgical treatments for urinary incontinence, and has the added benefit of being associated with other health improvements as well.

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