Researchers have recently reported that weight loss reduces urinary incontinence in overweight and obese women. An estimated 13 million Americans, most of them women, suffer from urinary incontinence. Women usually experience either stress and/or urge urinary incontinence. “Stress” urinary incontinence is the leakage of small amounts of urine during physical activity, such as coughing, sneezing, and exercising. “Urge” urinary incontinence is the leakage of large amounts of urine at unexpected times, including during sleep. Many women who have the disorder suffer in silence due to embarrassment. Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence has been lacking.
The NIDDK’s “Program to Reduce Incontinence by Diet and Exercise" (PRIDE) study recruited 338 obese and overweight women who leaked urine at least 10 times per week to determine whether a weight loss program could significantly reduce the frequency of urinary incontinence. The women were randomly assigned to one of two groups--one that participated in an intensive 6-month weight loss program of diet, exercise, and behavioral modification; or another that received information about diet and exercise, but no training to help them change their lifestyle. After 6 months, the investigators reported that women in the intensive group lost an average of 8 percent of their body weight (about 17 pounds) and reduced weekly urinary incontinence episodes by nearly one-half (47 percent). In contrast, women in the information-only group lost an average of 1.6 percent of body weight (about 3 pounds) and had 28 percent fewer episodes. Among women in the intensive treatment group, 41 percent achieved a clinically important reduction of at least 70 percent of weekly total incontinence episodes, whereas 22 percent of women in the information-only group achieved the same level of reduction. PRIDE provides high-level evidence that a behavioral intervention reduces urinary incontinence in overweight and obese women, thereby permitting patients and their health care providers to make better informed and personalized treatment decisions to improve this disorder.
Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 360: 481-490, 2009.