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Weight loss to treat urinary incontinence in overweight and obese women.

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.)

Pubmed ID: 19179316


  • Subak LL
  • Wing R
  • West DS
  • Franklin F
  • Vittinghoff E
  • Creasman JM
  • Richter HE
  • Myers D
  • Burgio KL
  • Gorin AA
  • Macer J
  • Kusek JW
  • Grady D
  • PRIDE Investigators


The New England journal of medicine

Publication Data

January 29, 2009

Associated Grants

  • Agency: NIDDK NIH HHS, Id: K24 DK080775
  • Agency: NIDDK NIH HHS, Id: U01 DK067860
  • Agency: NIDDK NIH HHS, Id: U01 DK067860
  • Agency: NIDDK NIH HHS, Id: U01 DK067860-05S1
  • Agency: NIDDK NIH HHS, Id: U01 DK067861
  • Agency: NIDDK NIH HHS, Id: U01 DK067861
  • Agency: NIDDK NIH HHS, Id: U01 DK067861-03
  • Agency: NIDDK NIH HHS, Id: U01 DK067862
  • Agency: NIDDK NIH HHS, Id: U01 DK067862-02

Mesh Terms

  • Behavior Therapy
  • Body Mass Index
  • Combined Modality Therapy
  • Diet, Reducing
  • Exercise
  • Female
  • Humans
  • Middle Aged
  • Obesity
  • Overweight
  • Urinary Incontinence
  • Weight Loss