Introduction:
Obesity is on the rise worldwide and can cause many systemic diseases. According to the global disease burden, nearly four million individuals die yearly due to being overweight or obese. Obesity can cause health issues like heart disease, diabetes, high blood pressure, and certain cancers. Studies have found a relationship between obesity and urinary incontinence.
What Is Obesity?
Obesity is a complex disease due to excessive fat accumulation in the body. This condition may cause several diseases, leading to poor health. Excess fat in the body may change the way it functions. These changes may further worsen the situation and lead to adverse health effects.
Obesity has tripled worldwide since 1975. Not only adults but even children are found to be obese. According to the WHO, 39 million children under the age of five were found to be obese in 2020.
The main cause of obesity and overweight is the energy imbalance between calories consumed and calories expended. This can occur due to the intake of high-energy foods containing fat and sugar and decreased physical activity. Urbanization, the increased sedentary nature of work, and changing modes of transportation are reasons for decreased physical activity.
Shedding excess weight may lead to reduced health impacts. Maintaining weight is as important as losing weight. The body mass index (BMI) can measure obesity. Sometimes it is also possible for the average weight to be obese. Health risks may be present if a person's weight is average and body fat is excessive.
One more way to measure obesity is by measuring waist circumference. An individual with a higher waist circumference may have higher health risks. Obesity can cause 300,000 deaths a year and is responsible for 100 billion dollars in health expenditures a year.
Obesity can be prevented; hence, by preventing this condition, many health risks and even deaths due to obesity may be avoided or reduced.
What Is Urinary Incontinence?
The inability of an individual to hold urine and suffering from leakage of urine due to actions like sneezing, laughing, and coughing are responsible for causing the increased pressure in the abdomen.
This condition is more common among 50 % of middle-aged and older women, and their quality of life is also affected due to this condition. The health expenditure due of urinary incontinence in the United States is estimated to be $ 30 billion every year.
There are different types of urinary incontinence.
They are
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Stress Incontinence: In this type, there is a leakage of urine due to pressure exerted on the urinary bladder due to coughing, sneezing, laughing, exercising, and lifting heavy objects.
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Urge Incontinence: In this type of incontinence, there is a sudden and intense urge to pass urine, followed by loss of urine. This condition occurs due to infection, severe neurological disorders, and diabetes.
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Overflow Incontinence: In this type of incontinence, affected individuals experience constant or frequent dribbling of urine. This may be due to the bladder's inability to empty urine.
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Functional Incontinence: In this type, because of physical or mental impairment, an individual may not be able to urinate in time.
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Mixed Incontinence: In this type, more than one type of incontinence can be observed. More commonly, urge incontinence and stress incontinence can be observed.
How Are Obesity and Urinary Incontinence Related?
Obesity and urinary incontinence are associated with each other. Many studies have found that there is a direct association between them. Obesity is found to be an independent and important risk factor that increases stress and is responsible for mixed urinary incontinence.
A study has shown that whenever there is an increase of five units in BMI (body mass index), there is an increased risk of 60 to 100 % of daily urinary incontinence. When this study was followed up for five to 10 years, it was observed that there was an increase of seven to 12 % in urinary incontinence for each 1 kg/m2 unit increase in BMI. This association between obesity and urinary incontinence is found to be strongest for stress and mixed incontinence and weaker for urge incontinence and overactive bladder syndrome.
A study has shown that obesity may cause nocturia by increasing urine production and the frequency of urination at night. The exact mechanism is not clearly understood. It is thought that excessive eating and drinking, especially alcohol at night, may be a reason for nocturia in obese people. Apart from this reason, pressure in the abdomen may cause nocturia. There is an enlarged prostate gland among obese men. Hence, obesity may increase the risk of nocturia by causing benign prostate hyperplasia (BPH).
Role of Abdominal Fat: Abdominal fat around the abdomen is one of the important factors related to obesity and urinary incontinence. BMI and waist-to-hip ratio are indicators of obesity. Obesity is directly related to stress incontinence, a type of urinary incontinence. Obesity is not directly related to urge and mixed urinary incontinence.
Role of Reduction in Weight: It has been found that reducing weight and surgeries to reduce weight play an important role in the beneficial effect on symptoms of urinary incontinence. Weight reduction along with lifestyle modifications like a low-calorie liquid diet, a balanced diet, and exercises help improve urinary incontinence symptoms.
Pathology: The exact pathology behind obesity and urinary incontinence is not known. Some studies have found that excess body weight exerts pressure on the abdomen. This, in turn, increases the pressure on the bladder and the mobility of the urethra. This causes stress urinary incontinence and an overactive urinary bladder.
In the case of pregnancy, increased weight may cause chronic strain, stretching, and weakening of the nerves and muscles in the pelvic area. These are hence considered to be responsible for urinary incontinence.
Since the exact pathology is not known, further studies on neurophysiology and urodynamics are required to learn more about obesity and urinary incontinence.
Conclusion:
Obesity is a complex condition that is responsible for causing various health problems. Out of those health problems, urinary incontinence is one of them. It acts as an important risk factor for urinary incontinence. Hence, it becomes important to know about obesity, urinary incontinence, and how they are related. Knowing helps an individual identify the problem and reach the healthcare provider early. Early diagnosis always helps in getting effective treatment. This, in turn, helps achieve a good quality of life.
