Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking. In a recently published study by Subak and colleagues , 338 overweight and obese women, with a mean age of 53 ± 11 years, and with at least ten urinary incontinence episodes per week, were randomly assigned to an intensive 6-month weight-loss program, including diet, exercise, and behavior modification (n = 226) or to a structured education program (n = 112). The body mass index and the weekly number of incontinence episodes were similar in the intervention group and the control group at baseline. The women in the intervention group had a mean weight loss of 8.0% (7.8 kg), as compared with 1.6% (1.5 kg) in the control group (p < 0.001). After 6 months, the mean weekly number of incontinence episodes decreased by 47% in the intervention group, compared with 28% in the control group (p = 0.01). The intervention group had a greater decrease in the frequency of stress incontinence episodes (p = 0.02), but not of urge incontinence episodes (p = 0.14) compared with the control group. A higher proportion of the intervention group than of the control group had a clinically relevant reduction of 70% or more in the frequency of all incontinence episodes (p < 0.001), stress incontinence episodes (p = 0.009), and urge incontinence episodes (p = 0.04). Thus the behavioral intervention targeting weight loss reduced the frequency of self-reported urinary incontinence episodes among overweight and obese women as compared with the control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction.
Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 2009;360:481-90. Published January 29, 2009.
Monz B, Chartier-Kastler E, Hampel C, et al. Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Eur Urol 2007;51:1073-81.