Urologic Diseases Research Updates
Spring/Summer 2009

Weight Loss in Overweight and Obese Women Reduces Urinary Incontinence

Reducing urinary incontinence (UI) can now be added to the extensive list of health benefits of weight loss, according to a clinical trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Office of Research on Women’s Health. The results of the trial were reported in the January 29, 2009, issue of the New England Journal of Medicine.

The Program to Reduce Incontinence by Diet and Exercise (PRIDE), conducted in Birmingham, AL, and Providence, RI, recruited 338 obese and overweight women who leaked urine at least 10 times per week. The women were randomly assigned to either an intensive 6-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 reported that women in the intensive weight-loss group lost an average of 8 percent of their body weight—about 17 pounds—and reduced weekly UI episodes by 47 percent. In contrast, women in the information-only group lost an average of 1.6 percent of their body weight—about 3 pounds—and had 28 percent fewer UI episodes.

“Clearly, weight loss can have a significant, positive impact on urinary incontinence, a finding that may help motivate weight loss,” said NIDDK Director Griffin P. Rodgers, M.D., M.A.C.P.

UI affects more than 13 million women in the United States and accounts for an estimated $20 billion in annual health care costs. Obesity is an established and modifiable risk factor for UI, but the PRIDE trial is the first to provide evidence supporting weight loss as a treatment for incontinence.

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

At 6 months, women in the intensive weight-loss group were significantly more satisfied with the change in their UI than were women in the information-only group. This finding was assessed through self-reported change in frequency of UI, volume of urine loss, degree to which UI was a problem, and satisfaction with the change in UI.

“Studies have documented that behavioral interventions help people lose weight, which helps decrease the risk of developing type 2 diabetes and high blood pressure, improve control of high blood pressure and cholesterol levels, and enhance mood and quality of life,” said Leslee L. Subak, M.D., an associate professor at the University of California, San Francisco and the lead study author. “Our 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 in overweight and obese women.”

Weight loss in PRIDE is comparable with that observed in the Diabetes Prevention Program (DPP) and in the ongoing Action for Health in Diabetes (Look AHEAD) trial, two NIDDK-sponsored clinical trials for people with type 2 diabetes. The PRIDE intensive weight-loss program was modeled after these two trials.

For more information about PRIDE, go to www.ClinicalTrials.gov and search for NCT00091988.

For information about the DPP and Look AHEAD trials, see www.diabetes.niddk.nih.gov/dm/pubs/preventionprogram and www2.niddk.nih.gov/Research/ScientificAreas/Obesity/ClinicalStudies/AHEAD.

More information about UI in women can be found at www.kidney.niddk.nih.gov/kudiseases/pubs/uiwomen. For free fact sheets and easy-to-read booklets about UI and other urologic disorders, visit the National Kidney and Urologic Diseases Information Clearinghouse at www.kidney.niddk.nih.gov.

NIH Publication No. 09–5743
August 2009

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