CHICAGO — Obese and overweight women with urinary incontinence may be able to manage their condition by losing weight and maintaining the weight loss.
The more weight a woman had lost by the end of the 18-month Program to Reduce Incontinence by Diet and Exercise trial, the greater her likelihood of experiencing at least a 70% improvement in urinary incontinence (UI), Dr. Leslee L. Subak reported at the annual meeting of the American Urogynecologic Society.
The finding that even moderate weight loss yielded significant improvements indicates that “weight loss should be considered as a first-line treatment for overweight and obese women with UI,” added Dr. Subak of the University of California, San Francisco.
The multicenter study consisted of 338 overweight and obese women who had at least 10 episodes of urinary incontinence weekly, as indicated by a 7-day voiding diary. The patients were randomly assigned to an intensive 6-month weight-loss program and a 12-month weight-maintenance program, or to an education program that did not include weight-reduction intervention.
The weight-loss program incorporated diet, exercise, and behavior modification. All of the participants kept diaries of the number and type of UI episodes.
At baseline, the intervention and control groups did not differ in mean age (53 years), weight (97 kg), body mass index (36 kg/m
After 18 months, participants in the diet and exercise group had lost a mean of 6.5 kg, and those in the education group had lost a mean of 1.7 kg. Although the two groups did not differ in frequency of total, stress, or urge incontinence episodes at the end of the trial, the data showed a strong relationship between the amount of weight lost and the likelihood of a significant reduction in UI.
Comparisons of UI frequency among women who gained weight during the study and among those who lost less than 5%, 5% to less than 10%, or 10% or more of their initial body weight showed a significant association between degree of weight loss and reductions in total, stress, and urge incontinence. The association persisted independently of treatment group or baseline BMI.
Compared with the participants who gained weight during the trial, the odds of experiencing at least a 70% reduction in overall total UI episodes were 1.8 in women who lost less than 5%, 2.0 in those who lost 5% to less than 10%, and 2.6 in those who lost 10% or more of their weight.
The trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases.