For overweight and obese women, loss of between five and 10% of body weight significantly reduces urine leakage. According to the research report in last month’s Obstetrics & Gynecology journal, weight loss should be the first approach to urine leakage in overweight and obese women.
The other word for urine leakage is incontinence: an involuntary loss of urine. It’s a major problem that isn’t much talked about. It’s not exactly dinner-party conversation material. You can imagine its effect on quality of lifeIn the U.S., leakage of urine on at least a weekly basis is reported byone in 10 women and one in 20 men. It’s more common at higher ages and in women. Just looking at non-pregnant women, incontinence affects 7% of women aged 20-39, 17% of those aged 40-59, and 23% of women 60-79 years old.
The study at hand involved 338 overweight and obese women: average age 53 (minimum of 30), average body mass index 36, average weight 92 kg (202 lb). For participation, they had to have at least 10 incontinence episodes per week. On average, they reported 24 leakage episodes per week (10 stress incontinence, 14 urge incontinence). All women were given a “self-help incontinence behavioral booklet with instructions for improving bladder control.” They were randomized to two different weight-loss programs, but I won’t bore you with the details. The diets were the standard reduced-calorie type. One diet group had many more meetings than than the other.
The women kept diaries of leakage, and even collected urine soaked pads for weighing.
Eight-five percent of the women completed the 18-month study.
By six months, 89 of the women has lost five to 10% of body weight; 84 lost over 10%. As expected, when measured at 18 months, only 61 women were in the “five to 10% loss” category; 71 were in the “over 10%” group.
Greater amounts of weigh loss were linked to fewer episodes of leakage. Maximal improvement in leakage episodes were seen in the women who lost between five and 10% of body weight, with no additional benefit to greater degrees of weight loss, generally.
Women who lost 5-10% of their body weight were two to four times more likely to achieve at least a 70% redcution in total and urge incontinent episode frequency compared with women who gained weight at 6, 12, and 18 months.
Weight loss works better for stress incontinence than for urge incontinence.
Three of every four women who lost five to 10% of body weight said they were moderately or very satisfied with their improved bladder control.
Weight loss is usually not a cure for incontinence, but a reasonable management option for overweight and obese women. It’s going to take loss of five or 10% of body weight. Other options include drugs, surgery, Kegel exercises, and just living with it.
Five or 10% weight loss for a 200 pound woman is just 10 or 20 pounds. That degree of weight loss is also linked to lower risk of diabetes and hypertension: even more reason go for it.
Does it work for men? Who knows?
Reference: Wing RR, Creasman JM, West DS, Richter HE, Myers D, Burgio KL, Franklin F, Gorin AA, Vittinghoff E, Macer J, Kusek JW, Subak LL, & Program to Reduce Incontinence by Diet and Exercise (2010). Improving urinary incontinence in overweight and obese women through modest weight loss. Obstetrics and gynecology, 116 (2 Pt 1), 284-92 PMID: 20664387