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Full Text of Background We randomly assigned 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 Weight loss marshall mn modification patients or to a structured education program patients. Full Text Weight loss marshall mn Methods The women in the Weight loss marshall mn group had a mean weight loss of 8.
Full Text of Results 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. Full Text of Discussion We recruited women between July and April in Providence, Rhode Island, and Birmingham, Alabama.
Women were eligible for the study if they were at least 30 years of age, had a body-mass index BMI, the weight in kilograms divided by the square of the height in meters of 25 to 50, and at baseline reported 10 or more urinary-incontinence episodes in a 7-day diary of voiding. The participants were required Weight loss marshall mn monitor their food intake and physical activity for 1 week, to be able to walk unassisted for two blocks approximately m without stopping, and to agree not to initiate new treatments for incontinence or weight reduction for the duration of the study.
Previous medical therapy for incontinence or obesity did not affect eligibility. Exclusion criteria included use of medical therapy for incontinence or weight loss within the previous month, current urinary tract infection or four or more urinary tract infections in the previous year, a history of incontinence of neurologic or functional origin due to factors not involving the lower urinary tract, such as chronic impairment of physical or cognitive functioningprevious surgery for incontinence or urethral surgery, major medical or genitourinary tract conditions, pregnancy or parturition in the previous 6 months, type 1 or type 2 diabetes mellitus requiring medical therapy that increased the risk of hypoglycemia, and uncontrolled hypertension.
The study was approved by the institutional review board at each site, and written informed consent was obtained from all participants before enrollment. Slim-Fast, a meal-replacement Weight loss marshall mn, was donated by the manufacturer, Unilever, which had no role in trial design, data accrual, data analysis, or preparation of the manuscript.
The biostatistician authors at the University of California, San Francisco, vouch for the completeness and accuracy of the data. Eligible participants were randomly assigned at a ratio to an intensive 6-month behavioral weight-loss program or to a structured four-session education program the control group. Randomization was performed with the use of randomly permuted blocks of three or six, stratified according to clinical center, with random assignment concealed in tamper-proof envelopes.
The participants were aware of their treatment assignment, but the staff members who collected the outcome data were not. The participants completed questionnaires concerning their demographic characteristics, medical and behavioral history, and history of incontinence that were routinely used by the investigators.
The participants were weighed to the nearest 0. Height was measured at baseline to the nearest centimeter with the use of a calibrated, wall-mounted stadiometer and a horizontal measuring block. The participants were trained to complete a 7-day diary of voiding see the Supplementary Appendixavailable with the full text of this article at NEJM. According to the instructions provided, the participants identified each episode as stress incontinence involuntary Weight loss marshall mn of urine with coughing, sneezing, straining, or exerciseurge incontinence Weight loss marshall mn of urine associated with a strong need or urge to voidor other.
For the purposes of analysis, each woman was then classified as having stress-only incontinence, stress-predominant incontinence i.
Weight loss marshall mn
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