Advertisements on TV make urinary incontinence seem like a joke, but to the more than 13 million American women with the problem, it is not funny. Incontinence, involuntary loss of urine, is reported by 50 percent of women over 60, and though men suffer from the problem as well, most sufferers are female. Incontinence can come at any age but as we grow older hormonal and body changes can exacerbate the problem. Incontinence comes in several forms, including stress incontinence—caused by laughing, sneezing or coughing—and urge incontinence, the sudden need to urinate.

Information published in the January 29 issue of the New England Journal of Medicine indicates that weight may be a factor in the problem. Lead author Dr. Leslee Subak, an associate professor in the departments of obstetrics, gynecology, reproductive sciences, urology and epidemiology and biostatistics at the University of California, San Francisco and her associates found that weight loss can help to control the problem. According to Subak, “Weight is one of the biggest risk factors for developing incontinence and for worsening incontinence.”

The women were randomly assigned to either an intervention group or a control group. Two-thirds were in the intervention group for diet, exercise and behavior modification. The remaining one-third, the control group, received four educational sessions about weight loss, healthful eating and physical activity. All participants received self-help information with tips for improving their incontinence.

The intervention group met for one hour every week, for six months. This group was on a structured diet and exercise plan to help them lose 7 to 9 percent of their starting weight. The intervention group averaged a loss of 8 percent of their body weight, around 17 pounds each, while the control group lost 1.6 percent, or about three pounds each. At the end of six months the intervention group had reduced weekly incontinence episodes by 47 percent. The control group had improved by 28 percent. The intervention group had fewer episodes of stress incontinence, but no improvement in urge incontinence.

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