By Linda Carroll

(Reuters Health) – Young and middle-aged women who are overweight or obese may be more likely to develop a leaky bladder, researchers say.

Australian researchers found that obese women were twice as likely as those at normal weight to leak urine, according to a paper in Obesity Reviews.

The effect was smaller among women who were overweight but not obese. These women were 35 percent more likely to be incontinent compared to normal-weight women.

While urine leakage may not severely impact health, “it can have significant impact on women’s well-being,” concluded the research team, led by Tayla Lamerton of the School of Movement and Nutrition Sciences at the University of Queensland. “Negative health outcomes associated with urinary incontinence include physical discomfort, odor and embarrassment.”

That fallout can, in turn, affect “physical activity, sleep and personal relationships,” the researchers wrote.

To determine the impact of obesity on urine leakage, Lamerton and her colleagues scoured the medical literature for studies with information on incontinence and weight. They settled on 14 studies that contained data on 47,293 women from eight countries: Australia, France, the US, Denmark, England, Scotland, Wales and the Netherlands. Studies were included only if the average age of the women was under 55.

Ultimately the researchers selected eight of the studies to include in a larger reanalysis. By combining the data from all eight, they were able to come up with stronger findings than any single study could provide.

After looking at incontinence overall, the researchers checked to see if there was any difference in the effects of weight on two different types: urge incontinence and stress incontinence. There wasn’t.

Urge incontinence, or overactive bladder, occurs when “the bladder squeezes and pushes urine out when you’re not asking it to,” explained Dr. Stephanie Kielb, an associate professor of urology, medical education and gynecology at Northwestern University’s Feinberg School of Medicine in Chicago. “Stress incontinence occurs when there is increased pressure on the abdomen and you leak urine after sneezing or coughing.”

Stress incontinence can develop when women are pregnant or when they are overweight because both “put so much more stress on the hammock of muscles and connective tissue at the bottom of the pelvis that holds the bladder and uterus in place,” Kielb, who was not affiliated with the new research, told Reuters Health by phone. “Overactive bladder is thought to be caused more by metabolic changes (that come with being overweight or obese). But nobody understands what causes it exactly.”

The new research showed that excess pounds can affect the risk of incontinence in all women, said Dr. Jeanne Clark, a professor of medicine and director of the division of general and internal medicine at Johns Hopkins Medicine in Baltimore, Maryland.

“People often think of this as something that affects older women,” said Clark, who is not affiliated with the new study. “But this shows it can affect younger women, too. And being overweight or obese is a risk factor.”

While it’s estimated that nearly 50 percent of women experience incontinence at some point, “fewer than half seek care,” Clark said by phone. “If it comes on all of a sudden, you should seek care because it could be due to a urinary tract infection. If it comes on gradually, you should still get it checked out because there are some things that can be done to help.”

Women who develop incontinence after putting on excess pounds will often see improvements if they lose weight, Clark said. And women who are overweight or obese and haven’t yet developed incontinence “should think about losing weight because that might prevent it from developing,” Clark said.

SOURCE: Obesity Reviews, online September 19, 2018.