Improving urinary incontinence in overweight and obese women through modest weight loss.
OBJECTIVE
To examine the relationship between magnitude of weight loss and changes in urinary incontinence frequency.


METHODS
Overweight and obese women (N=338) with 10 or more urinary incontinence episodes per week were assigned randomly to an intensive 6-month behavioral weight loss program followed immediately by a 12-month weight maintenance program (intervention; n=226) or to a structured education program (control; n=112). The intervention and control groups were combined to examine the effects of the magnitude of weight loss on changes in urinary incontinence assessed by 7-day voiding diary, pad test, and self-reported satisfaction with change in urinary incontinence.


RESULTS
Compared with participants who gained weight (reference), those who lost 5% to less than 10% or 10% or more of their body weight had significantly greater percent reductions in urinary incontinence episodes and were more likely to achieve at least a 70% reduction in the frequency of total and urge urinary incontinence episodes at 6, 12, and 18 months. Satisfaction was also related to magnitude of weight loss; approximately 75% of women who lost 5% to less than 10% of their body weight reported being moderately or very satisfied with their changes in urine leakage.


CONCLUSIONS
Weight losses between 5% and 10% of body weight were sufficient for significant urinary incontinence benefits. Thus, weight loss should be considered as initial treatment for incontinence in overweight and obese women.


BACKGROUND
ClinicalTrials.gov, www.clinicaltrials.gov, NCT00091988.


METHODS
II.
Wing
Rena R
RR
From the Miriam Hospital, Providence, Rhode Island; the Departments of Psychiatry and Human Behavior and Obstetrics & Gynecology, Warren Alpert Medical School at Brown University, Providence, Rhode Island; the Departments of Medicine, Epidemiology & Biostatistics, Obstetrics, Gynecology & Reproductive Sciences, and Urology, University of California, San Francisco, San Francisco, California; the University of Arkansas for Medical Sciences, College of Public Health, Little Rock, Arkansas; the Departments of Obstetrics and Gynecology, Medicine, and Maternal and Child Health, University of Alabama at Birmingham, Birmingham, Alabama; the Department of Veterans Affairs, Birmingham, Alabama; the Department of Psychology, University of Connecticut, Storrs, Connecticut; and the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
Creasman
Jennifer M
JM
West
Delia Smith
DS
Richter
Holly E
HE
Myers
Deborah
D
Burgio
Kathryn L
KL
Franklin
Frank
F
Gorin
Amy A
AA
Vittinghoff
Eric
E
Macer
Judith
J
Kusek
John W
JW
Subak
Leslee L
LL
D000328:Adult; D015992:Body Mass Index; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy*; D050177:Overweight / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy*; D015431:Weight Loss