No Weighting – The Support Group
You can add incontinence relief to the list of benefits obese patients gain from losing weight, according to a recent NIH-funded clinical trial.
I had to ask myself today what are we doing about the weight factor among my patients with incontinence. I have gone to great lengths to provide for all other aspects of pelvic floor heath. We have become fanatics when comes to pelvic floor fitness. We provide biofeedback and functional electrical stimulation. We provide hormonal therapy and neuromodulation. We provide surgical solutions and advanced neurophysiologic diagnostic testing. All of this and nothing besides “you would benefit from weight loss”.
Well it is time to do better. I am happy to introduce the “7 at 7” weight loss program for women with pelvic floor disorders.
The Program to Reduce Incontinence by Diet and Exercise (PRIDE) recruited 338 obese and overweight women (BMI 25-50) who reported at least 10 episodes of stress or urge incontinence weekly. All of them received a booklet with basic information on managing leaks and strengthening the pelvic floor. They were then randomly divided into two groups.
After six months, those enrolled in an intensive weight-loss regimen lost an average of 8% of their body weight, about 17 pounds. Their weekly incontinence episodes declined by 47%. The control group attended general education sessions about healthy eating and physical activity. They lost only 1.6% of their body weight on average, about 3 pounds, but they had 28% fewer incontinence episodes. N Engl J Med. 2009;360:481-490