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Weight loss to treat urinary incontinence in overweight and obese women.
N Engl J Med. 2009 Jan 29; 360(5):481-90.NEJM

Abstract

BACKGROUND

Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking.

METHODS

We randomly assigned 338 overweight and obese women with at least 10 urinary-incontinence episodes per week 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).

RESULTS

The mean (+/-SD) age of the participants was 53+/-11 years. The body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) and the weekly number of incontinence episodes as recorded in a 7-day diary of voiding were similar in the intervention group and the control group at baseline (BMI, 36+/-6 and 36+/-5, respectively; incontinence episodes, 24+/-18 and 24+/-16, respectively). The 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 (P<0.001). After 6 months, the mean weekly number of incontinence episodes decreased by 47% in the intervention group, as compared with 28% in the control group (P=0.01). As compared with the control group, the intervention group had a greater decrease in the frequency of stress-incontinence episodes (P=0.02), but not of urge-incontinence episodes (P=0.14). A higher proportion of the intervention group than of the control group had a clinically relevant reduction of 70% or more in the frequency of all incontinence episodes (P<0.001), stress-incontinence episodes (P=0.009), and urge-incontinence episodes (P=0.04).

CONCLUSIONS

A 6-month behavioral intervention targeting weight loss reduced the frequency of self-reported urinary-incontinence episodes among overweight and obese women as compared with a control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction. (ClinicalTrials.gov number, NCT00091988.)

Authors+Show Affiliations

University of California, San Francisco, San Francisco, USA. subakl@obgyn.ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19179316

Citation

Subak, Leslee L., et al. "Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women." The New England Journal of Medicine, vol. 360, no. 5, 2009, pp. 481-90.
Subak LL, Wing R, West DS, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481-90.
Subak, L. L., Wing, R., West, D. S., Franklin, F., Vittinghoff, E., Creasman, J. M., Richter, H. E., Myers, D., Burgio, K. L., Gorin, A. A., Macer, J., Kusek, J. W., & Grady, D. (2009). Weight loss to treat urinary incontinence in overweight and obese women. The New England Journal of Medicine, 360(5), 481-90. https://doi.org/10.1056/NEJMoa0806375
Subak LL, et al. Weight Loss to Treat Urinary Incontinence in Overweight and Obese Women. N Engl J Med. 2009 Jan 29;360(5):481-90. PubMed PMID: 19179316.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Weight loss to treat urinary incontinence in overweight and obese women. AU - Subak,Leslee L, AU - Wing,Rena, AU - West,Delia Smith, AU - Franklin,Frank, AU - Vittinghoff,Eric, AU - Creasman,Jennifer M, AU - Richter,Holly E, AU - Myers,Deborah, AU - Burgio,Kathryn L, AU - Gorin,Amy A, AU - Macer,Judith, AU - Kusek,John W, AU - Grady,Deborah, AU - ,, PY - 2009/1/31/entrez PY - 2009/1/31/pubmed PY - 2009/2/7/medline SP - 481 EP - 90 JF - The New England journal of medicine JO - N Engl J Med VL - 360 IS - 5 N2 - BACKGROUND: Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence is lacking. METHODS: We randomly assigned 338 overweight and obese women with at least 10 urinary-incontinence episodes per week 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). RESULTS: The mean (+/-SD) age of the participants was 53+/-11 years. The body-mass index (BMI) (the weight in kilograms divided by the square of the height in meters) and the weekly number of incontinence episodes as recorded in a 7-day diary of voiding were similar in the intervention group and the control group at baseline (BMI, 36+/-6 and 36+/-5, respectively; incontinence episodes, 24+/-18 and 24+/-16, respectively). The 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 (P<0.001). After 6 months, the mean weekly number of incontinence episodes decreased by 47% in the intervention group, as compared with 28% in the control group (P=0.01). As compared with the control group, the intervention group had a greater decrease in the frequency of stress-incontinence episodes (P=0.02), but not of urge-incontinence episodes (P=0.14). A higher proportion of the intervention group than of the control group had a clinically relevant reduction of 70% or more in the frequency of all incontinence episodes (P<0.001), stress-incontinence episodes (P=0.009), and urge-incontinence episodes (P=0.04). CONCLUSIONS: A 6-month behavioral intervention targeting weight loss reduced the frequency of self-reported urinary-incontinence episodes among overweight and obese women as compared with a control group. A decrease in urinary incontinence may be another benefit among the extensive health improvements associated with moderate weight reduction. (ClinicalTrials.gov number, NCT00091988.) SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/19179316/Weight_loss_to_treat_urinary_incontinence_in_overweight_and_obese_women_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa0806375?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -