The Obesity Epidemic: Not Just Bad for Your Waistline

  • Everyone is talking about the obesity epidemic these days. There are multiple news magazine shows and reality shows devoted to this topic. It is a real health emergency in this country.


    According to the CDC, "Data from two NHANES surveys show that among adults aged 20-74 years the prevalence of obesity increased from 15.0% (in the 1976-1980 survey) to 32.9% (in the 2003-2004 survey)." Obesity is not only dangerous, but extremely costly for the medical field. Billions of dollars are spent annually to treat medical conditions the are directly obesity related, like high blood pressure and diabetes.

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    More indirect effects of obesity are never accounted for in this figure, like stress incontinence. One of the most difficult things I have to do as a physician is tell people they are overweight and that they need to do something about it. Most of my patients know they are overweight, and even though I am their doctor, they don't want to hear it from me. Obesity is not only a major contributor to stress incontinence, but surgical repair is very difficult and leads to early failure and return of incontinence.


    I have addressed stress incontinence in several blogs in the past. Briefly, stress incontinence is urinary incontinence due to relaxation of the pelvic floor muscles and hypermobility of the urethra. Urine is able to leak out of the urethra when there is increased pressure put on the bladder from increased abdominal pressure.


    This is most commonly seen with coughing, sneezing, laughing, and lifting with exertion. When someone is overweight there is constant pressure on the bladder which causes increased relaxation of the pelvic floor causing stress incontinence early, not to mention that urinary incontinence tends to be worse because of the increased pressure. Once someone undergoes surgery for stress incontinence, it seems that they are at a much higher risk to have incontinence again within a shorter time period because of continued increased pressure on the bladder.


    I know that losing weight is one of the most difficult things someone can do. I know from personal experience, I promise. Unfortunately, the truth hurts, but the truth is if you have stress incontinence, and you are looking to have surgical correction, you would be helping yourself a great deal if you could lose even ten percent of you weight prior to surgery, and if that doesn't happen, well then keep on trying to lose weight even after the surgery. You won't only be helping your incontinence, but your overall health status, and that is the most important of all!

Published On: August 07, 2007