Weight Loss for Urinary Incontinence

Urinary incontinence affects millions of women and has a profound adverse effect on quality of life. Overweight and obesity are well known to make symptoms of incontinence worse and there is preliminary evidence suggesting that weight loss has a beneficial effect on symptoms in overweight and obese women.

Last week the N Engl J Med published the results of the PRIDE study (Program to Reduce Incontinence by Diet and Exercise), a large randomized trial in 338 overweight and obese women with at least 10 urinary-incontinence episodes per week. Patients were randomized to an intensive 6-month weight-loss program that included diet, exercise, and behavior modification (226 patients) or to a structured education program (112 patients).

The average age of the patients was around 53 years, the average BMI was 36; the weekly number of incontinence episodes was around 24/week. After six months, women in the intervention group had a mean weight loss of 8.0% (7.8 kg), as compared with 1.6% (1.5 kg) in the control group. The number of incontinence episodes decreased by 47% in the intervention group, as compared with 28% in the control group. The reduction was mainly seen in the frequency of stress-incontinence, but not of urge-incontinence episodes.

These findings suggest that urinary incontinence should be added to the long list of health problems that improve with moderate weight loss.