Women who put on more weight after their teen years are more likely to develop urinary incontinence later in life than women who have their weight under control. Urinary incontinence is a common condition in middle-aged women. Most of the previous studies on urinary incontinence have been limited to older women, although up to 40 per cent of women under the age of 60 years may also have it. Many studies have linked incontinence with excess weight, but these investigations were unable to show whether gaining weight caused the problem or vice versa, for example, it might be that incontinent women chose not to exercise, and gain weight as a result. To investigate the obesity-incontinence link over time in younger women, researchers from the Channing Laboratory at Brigham and Women's Hospital in Boston studied 30,982 women in the age group 37–54 years participating in the Nurses' Health Study. All had reported their weight at the age of 18 years, and gave updated information on their weight every two years. Women with a current body mass index (BMI) of 35 or above, indicating severe obesity, were more than twice as likely as women with BMIs below 23 to have developed incontinence during the course of the study. The findings suggested that the more weight women gained after the age of 18 years, the greater was their risk of developing urinary control problems. Women who gained from 5 to 10 kg were 44 per cent more likely to become incontinent than those who kept their weight within 2 kg of what it was at the age of 18 years, while those who gained more than 30 kg were at more than fourfold increased risk of incontinence compared to those who put on fewer than 2 kg. There are a number of possible explanations for why excess weight might worsen bladder control. Abdominal obesity is thought to boost pressure within the bladder, stressing the muscles responsible for controlling urination, while insulin resistance related to obesity may lead to nerve damage that impairs the brain's control over the bladder. However, women can certainly prevent urinary problems by keeping their weight under control.
Obstetrics & Gynecology,
August 2007