The Five-Per-Cent Solution to Incontinence
Shedding as little as 5% of body weight can relieve incontinence in women, according to a recent study from the University of California at San Francisco. According to lead researcher and professor of obstetrics and gynecology and reproductive sciences, epidemiology and biostatistics, and urology Dr. Leslee Subak, the results suggest that “improvement in incontinence may be another long-term benefit of weight loss, in this case surgical weight loss.” Urinary continence is not among the reasons people undergo bariatric surgery, but it could be a nice by-product of it. Furthermore, there is no reason weight loss achieved by any other means shouldn’t have the same result.
Subak and colleagues followed more than 1,500 severely obese women who participated in the multicenter Longitudinal Cohort Study of Bariatric Surgery-2 – funded by the National Institute of Diabetes and Digestive and Kidney Diseases – for three years. Almost 800 of the patients had incontinent episodes at least once a week, of which 7% had undergone incontinence surgery previously, while 8% had been or were being given medications or behavioral treatment for incontinence, as reported in the self-administered questionnaires about urinary incontinence episodes they completed before surgery
The majority of subjects underwent a Roux-en-Y gastric bypass (71%) or laparoscopic adjustable gastric banding (25%). They lost an average of 30% of their baseline weight after the first year, and the reduction was maintained through the third year. Moreover, there was a 70% remission rate – defined as less than one incontinent episode a week in the previous three months – in the first year, leveling off to 61%-62% in the second and third year. The women who reported urinary incontinence went from having an average of 11 weekly episodes 3 episodes a week at year 1 and four weekly episodes at years 2 and 3.
After the three years, 25% of the patients experience complete remission – no incontinent episodes in the previous three months. “Every 5% of weight loss from the patient’s baseline resulted in about a 30% greater chance of incontinence improvement. Because these women lost about six times more than that, their odds of improvement were about eight-fold greater,” Subak remarked.