Feb. 2, 2009 | Feb. 2, 2009 | Losing weight helps women reduce urinary incontinence, according to a clinical trial co-authored by a University of Arkansas for Medical Sciences (UAMS) researcher and published in the Jan. 29 issue of the New England Journal of Medicine.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Office of Research on Women’s Health (ORWH).

Delia West, Ph.D., professor of health behavior in the UAMS Fay W. Boozman College of Public Health and one of the original investigators in the trial, said the findings are significant in promoting good health in women.

“Urinary incontinence is something that we’re finding to be very common, but there aren’t a whole lot of people willing to talk about it,” West said. “The results suggest that a decrease in urinary incontinence is another health benefit associated with weight loss and that weight reduction can be a first-line treatment for incontinence in overweight and obese women.”

The Program to Reduce Incontinence by Diet and Exercise (PRIDE), conducted in Birmingham, Ala. and Providence, R.I., recruited a total of 338 obese and overweight women who leaked urine at least 10 times per week. The women were randomly assigned to either an intensive six-month weight-loss program of diet, exercise and behavior modification or to a group that received information about diet and exercise, but no training to help them change habits.

The investigators report that women in the intensive weight-loss group lost an average 8 percent of their body weight (about 17 pounds) and reduced weekly urinary incontinence episodes by nearly one-half (47 percent). In contrast, women in the information-only group lost an average 1.6 percent of body weight (about 3 pounds) and had 28 percent fewer episodes.  

“Clearly, weight loss can have a significant, positive impact on urinary incontinence, a finding that may help motivate weight loss, which has additional health benefits such as preventing type 2 diabetes,” said Griffin P. Rodgers, M.D., director of NIDDK.

Urinary incontinence affects more than 13 million women in the United States and accounts for an estimated $20 billion in annual health care costs, according to the study. Though obesity is an established risk factor for urinary incontinence, conclusive evidence detailing a positive effect of weight loss on urinary incontinence has been lacking. The PRIDE trial provides evidence supporting weight loss as a treatment for incontinence.

An important finding of the study is the difference between the two groups in the reduction of incontinence. Among women in the weight-loss group, 41 percent achieved a clinically relevant reduction of at least 70 percent of total incontinence episodes per week, whereas 22 percent of women in the information-only group achieved the same level of reduction.

At six months, women in the weight-loss group were significantly more satisfied with the change in their incontinence than were women in the information-only group. This was assessed through self-reported perceived change in frequency of incontinence, volume of urine loss, the degree to which incontinence was a problem, and satisfaction with the change in incontinence.

Lead author of the study was Leslee L. Subak, M.D., of the University of California, San Francisco (UCSF). Co-authors were West; Deborah Grady, M.D., M.P.H., professor of medicine at UCSF and the San Francisco Veterans Affairs Medical Center; Rena Wing, Ph.D., of The Miriam Hospital and the Warren Alpert Medical School at Brown University, Providence, R.I.; and Frank Franklin, M.D., Ph.D., of the University of Alabama in Birmingham.

For more information on PRIDE, go to http://www.clinicaltrials.gov/ and type NCT00091988 in the search window.

UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a new 540,000-square-foot hospital, six centers of excellence and a statewide network of regional centers. UAMS has 2,652 students and 733 medical residents. Its centers of excellence include the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute and the Donald W. Reynolds Institute on Aging. It is the state’s largest public employer with more than 10,000 employees, including nearly 1,150 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. Visit www.uams.edu or uamshealth.com.