title: Effect of weight loss on urinary incontinence in overweight and obese women: results at 12 and 18 months.
abstract: OBJECTIVE
  Initial weight loss improves urinary incontinence in overweight and obese women. In this study we examined the longer term effects of a weight loss intervention on urinary incontinence.
  
  
  METHODS
  Overweight and obese women (mean +/- SD age 53 +/- 10 years) with 10 or more urinary incontinence episodes weekly were randomized to an 18-month behavioral weight loss intervention (226) or control group (112). Outcome measures were collected at 12 and 18 months.
  
  
  RESULTS
  At baseline women had a mean body mass index of 36 +/- 6 kg/m(2) and reported a mean of 24 +/- 18 incontinence episodes weekly. Of the patients 86% completed 18-month measurements. The percent weight loss in the intervention group averaged 8.0%, 7.5% and 5.5% at 6, 12 and 18 months, respectively, vs approximately 1.5% in the control group (all values p <0.001). Compared with controls at 12 months the intervention group reported a greater percent reduction in weekly stress urinary incontinence episodes (65% vs 47%, p <0.001), and a greater proportion achieved at least a 70% decrease in weekly total and stress urinary incontinence episodes. At 18 months a greater proportion of women in the weight loss intervention group had more than 70% improvement in urge incontinence episodes but there were no significant differences between the groups for stress or total urinary incontinence. The intervention group also reported greater satisfaction with changes in urinary incontinence than the control group at 6, 12 and 18 months.
  
  
  CONCLUSIONS
  Weight loss intervention reduced the frequency of stress incontinence episodes through 12 months and improved patient satisfaction with changes in incontinence through 18 months. Improving weight loss maintenance may provide longer term benefits for urinary incontinence.
authors.affiliation: The Miriam Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island 02903, USA. rwing@lifespan.org
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
authors.forename: Delia Smith
authors.initials: DS
authors.lastname: West
authors.forename: Deborah
authors.initials: D
authors.lastname: Grady
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Creasman
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Deborah
authors.initials: D
authors.lastname: Myers
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Burgio
authors.forename: Frank
authors.initials: F
authors.lastname: Franklin
authors.forename: Amy A
authors.initials: AA
authors.lastname: Gorin
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Judith
authors.initials: J
authors.lastname: Macer
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Leslee L
authors.initials: LL
authors.lastname: Subak
mesh_terms: D001521:Behavior Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications*; D013997:Time Factors; D014549:Urinary Incontinence / Q000209:etiology* / Q000628:therapy*; D015431:Weight Loss