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The effect of weight loss on changes in health-related quality of life among overweight and obese women with urinary incontinence

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Abstract

Objective

To estimate the effect of change in weight and change in urinary incontinence (UI) frequency on changes in preference-based measures of health-related quality of life (HRQL) among overweight and obese women with UI participating in a weight loss trial.

Methods

We conducted a longitudinal cohort analysis of 338 overweight and obese women with UI enrolled in a randomized clinical trial comparing a behavioral weight loss intervention to an educational control condition. At baseline, 6, and 18 months, health utilities were estimated using the Health Utilities Index Mark 3 (HUI3), a transformation of the SF-36 to the preference-based SF-6D, and the estimated Quality of Well-Being (eQWB) score (a summary calculated from the SF-36 physical functioning, mental health, bodily pain, general health perceptions, and role limitations–physical subscale scores). Potential predictors of changes in these outcomes were examined using generalized estimating equations.

Results

In adjusted multivariable models, weight loss was associated with improvement in HUI3, SF-6D, and eQWB at 6 and 18 months (P < 0.05). Increases in physical activity also were independently associated with improvement in HUI3 (P = 0.01) and SF-6D (P = 0.006) scores at 18 months. In contrast, reduction in UI frequency did not predict improvements in HRQL at 6 or 18 months.

Conclusion

Weight loss and increased physical activity, but not reduction in UI frequency, were strongly associated with improvements in health utilities measured by the HUI3, SF-6D, and eQWB. These findings provide important information that can be used to inform cost–utility analyses of weight loss interventions.

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Acknowledgments

The authors wish to acknowledge the contribution made by PRIDE investigators, staff, consultants, sponsor and Data and Safety Monitoring Board.

Conflict of interest

Dr. West serves on the medical advisory board for Jenny Craig, Inc.

Author information

Authors and Affiliations

  1. Psychology Department, Baruch College, CUNY, 55 Lexington Avenue, B8-215, New York, NY, 10010, USA

    Angela Marinilli Pinto

  2. Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Leslee L. Subak, Sanae Nakagawa & Miriam Kuppermann

  3. Department of Epidemiology & Biostatistics, UCSF, San Francisco, CA, USA

    Leslee L. Subak, Eric Vittinghoff & Miriam Kuppermann

  4. Department of Urology, UCSF, San Francisco, CA, USA

    Leslee L. Subak

  5. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA

    Rena R. Wing

  6. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA

    John W. Kusek

  7. Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA

    William H. Herman

  8. Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Delia Smith West

Authors
  1. Angela Marinilli Pinto
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  2. Leslee L. Subak
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  3. Sanae Nakagawa
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  4. Eric Vittinghoff
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  5. Rena R. Wing
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  6. John W. Kusek
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  7. William H. Herman
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  8. Delia Smith West
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  9. Miriam Kuppermann
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Corresponding author

Correspondence to Angela Marinilli Pinto.

Additional information

Clinical Trial Registration for “PRIDE” is NCT00091988 in www.clinicaltrials.gov.

The study is conducted for the Program to Reduce Incontinence by Diet and Exercise (PRIDE).

Please refer “Appendix” section for PRIDE investigators, staff, consultants, sponsor and Data and Safety Monitoring Board.

Appendix

Appendix

The University of Alabama, Birmingham—Frank Franklin, MD, PhD (Principal Investigator), Holly Richter, PhD, MD (Co-Investigator), Leslie Abdo, BSN, RN, CCRC, Charlotte Bragg, MS, RD, LD, Kathy Burgio, PhD (Investigator), Kathy Carter, RN, BSN, Juan Dunlap, Stacey Gilbert, MPH, Sara Hannum, Anne Hubbell, MS, RD, LD, Karen Marshall, Lisa Pair, CRNP, Penny Pierce, RN, BSN, Clara Smith, MS, RD, Sue Thompson, RN, Janet Turman, Audrey Wrenn, MAEd.

The Miriam Hospital—Rena Wing, PhD (Principal Investigator), Amy Gorin, PhD (Co-Investigator), Deborah Myers, MD (Co-Investigator), Tammy Monk, MS, Rheanna Ata, Megan Butryn, PhD, Pamela Coward, MEd, RD, Linda Gay, MS, RD, CDE, Jacki Hecht, MSN, RN, Anita Lepore-Ally, RN, Heather Niemeier, PhD, Yael Nillni, Angela Pinto, PhD, Deborah Ranslow-Robles, Phlebotomist/MedAsst, Natalie Robinson, MS, RD, Deborah Sepinwall, PhD, Margaret E. Hahn, MSN, RNP, Vivian W. Sung, MD, MPH, Victoria Winn, Nicole Zobel.

The University of Arkansas for Medical Sciences—Delia West, PhD (Investigator). The University of Pennsylvania—Gary Foster, PhD (Consultant).

The University of California, San Francisco (Coordinating Center)—Deborah Grady, MD, MPH (Principal Investigator), Leslee Subak, MD (Co-PI), Judith Macer, Ann Chang, Jennifer Creasman, MSPH, Judy Quan, PhD, Eric Vittinghoff, PhD, Jennifer Yang.

Supported by grants #U01 DK067860, U01 DK067861 and U01 DK067862 from The National Institute of Diabetes and Digestive and Kidney Diseases—John W. Kusek, PhD, Leroy M. Nyberg, MD, PhD (Project Officers). Preparation of this manuscript was supported by 5K23DK075645 from The National Institute of Diabetes and Digestive and Kidney Diseases.

Data and Safety Monitoring Board

The University of Utah Health Sciences Center—Ingrid Nygaard, MD (DSMB Chairperson)

The Children’s Hospital Boston—Leslie Kalish, ScD

The University of California, San Diego—Charles Nager, MD

The Medical University of South Carolina—Patrick M. O’Neil, PhD

The Johns Hopkins School of Medicine—Cynthia S. Rand, PhD

The University of Virginia Health Systems—William D. Steers, MD

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Pinto, A.M., Subak, L.L., Nakagawa, S. et al. The effect of weight loss on changes in health-related quality of life among overweight and obese women with urinary incontinence. Qual Life Res 21, 1685–1694 (2012). https://doi.org/10.1007/s11136-011-0086-2

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