Another Good Reason to Lose the Fat: Stop Urine Leakage

For overweight and obese women, loss of between five and 10% of body weight significantly reduces urine leakage.  According to the research report in a recent 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 life.  In the U.S., leakage of urine on at least a weekly basis is reported by one 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.

Results

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% reduction 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.

Bottom Line

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?

Steve Parker, M.D.

Reference: Wing, R.R., et al.  Program to Reduce Incontinence by Diet and Exercise: Improving urinary incontinence in overweight and obese women through modest weight loss. Obstetrics and Gynecology, 116 (2010): 284-92 PMID: 20664387

2 Comments

Filed under Weight Loss

2 responses to “Another Good Reason to Lose the Fat: Stop Urine Leakage

  1. elisaannh

    I am just stunned. I had not thought about it, but after losing 78 pounds, I no longer have this issue! When I think back at how upset I was that it was happening, I seem to have complete control back, even being able to live full time on a truck with access to a restroom only 3 times a day. I had not known it was my weight gain during that time period that affected me in that way. Great article and much needed reminder at the different ways obesity affects us.

  2. Steve Parker, M.D.

    Thanks for noticing, elisaannh. Urine leakage is a silent epidemic.