Obesity and Incontinence: The Connection + How to Cope

Feet standing on a scale with a yellow measuring tape on the ground

Can Obesity Cause Incontinence?

Obesity, standardly classified as having a body mass index BMI) of 30 or higher, is a risk factor for urinary incontinence. No matter what your age or gender, people who are obese are more likely to develop urinary incontinence. Estimates believe that 46% to 67% of obese women experience incontinence. Fortunately, there are methods to help. Learn how much obesity increases your chances of incontinence, why the connection exists, and how to eliminate or manage your incontinence.


What Kind of Incontinence Does Obesity Cause?

Carrying excessive weight can lead to different types of urinary incontinence. According to a paper in Obesity Reviews, 70% of obese women showed signs of stress urinary incontinence. Stress incontinence, which occurs when you exert pressure on your bladder when coughing, sneezing, or exercising, can result from obesity due to excess weight in the midsection of your body. This can apply pressure on your pelvic floor, causing overactive bladder and increasing the likelihood of bladder leaks. 


How Are Obesity and Urinary Incontinence Connected?

There are several reasons obesity raises your risk for incontinence. Read more about the key connections between obesity and urinary incontinence below: 

Pelvic Floor Pressure

Extra weight around the middle section puts pressure and stress on your pelvic floor. Your pelvic floor muscles and urethral structures can weaken and this can lead to accidental urine leaks. This weakening sometimes becomes more apparent when sneezing, coughing, or jumping.

Type 2 Diabetes 

Obesity can also lead to Type 2 diabetes, which in turn causes a more frequent and urgent need to urinate. Type 2 diabetes damages the nerves that control your bladder, giving you less control over leaks. In addition, increased glucose levels in the blood can cause increased thirst and more frequent urination. 

Medications 

Some medications, including those for diabetes, can cause fluid retention or a cough, both of which can worsen incontinence or increase the risk of bladder sensitivity. Increased thirst can be another common side effect from medications. While it’s crucial to stay hydrated, especially if you have incontinence, excess water increases your need to urinate.


Does Belly Fat Cause Bladder Problems?

Carrying excess body weight in your belly area or midsection can lead to more frequent urination and bladder leaks. Increased pressure on your abdominal area can worsen bladder pressure and affect the mobility of the urethra. This leads to worsening stress incontinence, and to a lesser extent, urge incontinence. 

 

Can Losing Weight Help with Incontinence?

Fortunately, if your incontinence is caused by obesity, this can be reduced significantly by following a healthy weight loss plan, diet, or surgery. In several observational studies of severely overweight women with incontinence, it’s been shown that, following bariatric surgery, the prevalence of stress urinary incontinence significantly decreased. Losing weight without surgery works the same way and provides long-term benefits in terms of urinary incontinence. For many people, weight gain is connected to other health issues, and therefore it may be challenging to lose weight. In this situation, the focus is on managing the symptoms of incontinence. Managing the symptoms of incontinence can help result in a more comfortable, hassle-free experience. 

 

How to Manage Obesity Related Incontinence

Choose the right incontinence underwear

When it comes to preventing leaks, ensuring that you have well-fitting and comfortable incontinence underwear for day and night is key. To help make obesity-related incontinence more comfortable, look for the following when choosing incontinence underwear


Absorbency

Incontinence underwear is designed to soak up urine to protect your skin and prevent leaks from showing through your clothing. However, not all incontinence underwear is designed with the same type of absorbent material. Look for underwear that is designed with an absorbent core to help absorb and contain leaks. Overnight underwear is frequently the most absorbent, and can be worn for up to 12 hours. Disposable bed protectors can also be helpful to prevent leaks from getting onto bedding or furniture.


Size

Finding the right size of incontinence underwear for larger sizes can be difficult. Based on research, up to 50% of leaks can be caused by incorrect fit. To ensure underwear is both comfortable and leak-proof, consult the manufacturer’s size chart to ensure that the underwear fits comfortably around the waist. Few brands have sizing up to 2XL that will comfortably fit waist sizes up to 80 inches. Additionally, look for brands that reinforced leak guards around the leg holes to prevent leaks from escaping. Trying a few different brands for size and comfort may be the right solution before you commit to one product. 


Sensitive-skin

For many who are managing obesity-related incontinence, sensitive skin may also be an important consideration. If you’re prone to sensitive skin, look for incontinence products that are designed to quickly absorb liquid and wick moisture away from the body. Keeping skin dry helps to protect it from irritation and possible infection.


Manage your weight

In addition to choosing the right incontinence underwear, weight loss can be an effective long term solution to managing obesity related incontinence. Based on a recent study, study participants who lost 5-10% of their body weight had greater reductions in the frequency of urinary incontinence than those who did not experience weight loss. In addition to helping reduce the frequency of incontinence, modest weight losses of 5-10% are also helpful in reducing blood pressure and preventing diabetes. Working with your doctor to get a healthy weight loss plan in place can be a good first step to weight management for obesity-related incontinence. 


Pelvic floor exercises

Pelvic floor exercises, commonly referred to as Kegels, can strengthen your pelvic floor and make incontinence more manageable. By contracting your pelvic floor muscles to close around your pelvic floor area and lift, you can bring awareness to those muscles to improve bladder control. Working on sustained holds and quick flicks with Kegels can help build these muscles and reduce incontinence over time. Pelvic floor exercises require no equipment and can be done whether you’re at home, in the office, or on-the-go. 


Bladder training

Depending on your lifestyle and circumstances, bladder training could also be an effective method for managing obesity-related urge incontinence. During bladder training, you slowly increase the time between your bathroom breaks. For example, if you typically go to the bathroom every 30 minutes, you stretch it to 45 minutes, then an hour, etc. Over time, bladder training can lengthen the amount of time between bathroom trips, increase the capacity of your bladder, and diminish the sudden urge to urinate.

 

Take care of your skin

Staying comfortable can be one of the biggest challenges of excessive body weight and incontinence. Excessive fat tissue, limited mobility, and skinfolds all contribute to skin issues in overweight adults, and proactive management of skin health should be a priority. 


Control Moisture

Keeping moisture off the skin is the first step to preventing unwanted skin irritation. Warm, moist environments that can be found between skinfolds provide an ideal environment for microorganism growth. A common condition, candida albicans, also known as yeast, can grow out of control in these dark moist environments, leading to uncomfortable skin irritation. To prevent moisture from forming, avoid tight clothing, cleanse regularly with the help of disposable wipes, and inspect skin daily.


Rash in Body Folds

Developing a rash in body folds, also known as Intertrigo, can also be an uncomfortable symptom of obesity-related incontinence. To help maintain healthy skin in these areas, use a zinc-oxide based barrier cream to help protect the skin folds from irritation. 


Abdominal Fold 

Common in adults with obesity, excess abdominal fat and skin can lead to an abdominal pannus, or an abdominal fold. A large abdominal fold can lead to limited mobility, create unwanted pressure injury, and cause friction and chafing. Ensuring that the pannus stays dry, clean, and protected with the use of cleansing sprays, wipes, and barrier creams can help maintain proper skin health and comfort. 



Do you or someone you’re caring for experience obesity-related incontinence? Take our Bladder Protection Quiz and get a free starter pack for your loved one to try today!



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