Rena R Wing1, Jennifer M Creasman, Delia Smith West, Holly E Richter, Deborah Myers, Kathryn L Burgio, Frank Franklin, Amy A Gorin, Eric Vittinghoff, Judith Macer, John W Kusek, Leslee L Subak. 1. 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.
Abstract
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. CONCLUSION: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. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00091988. LEVEL OF EVIDENCE: II.
RCT Entities:
OBJECTIVE: To examine the relationship between magnitude of weight loss and changes in urinary incontinence frequency. METHODS: Overweight and obesewomen (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. CONCLUSION: 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 obesewomen. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00091988. LEVEL OF EVIDENCE: II.
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