Your doctor may have told you that you have urinary incontinence, and this could be stress urinary incontinence or an overactive bladder. One in 3.3 million Canadians, nearly 10% of the population, experience urinary incontinence, so you are not alone (1). Weight loss, through nutrition and exercise changes, is one of many strategies to reduce the frequency of stress urinary incontinence (2,3), but weight loss is easier said than done for many. Reducing the likelihood of yo-yo dieting and regaining weight is important when considering weight loss. If you are planning to make nutrition changes to support weight loss and a new lifestyle, here is a registered dietitians’ shortlist of some important things to consider, starting with letting go of past habits.

1. Nutrition misinformation – look for red flags

Many fad diets promote eliminating food groups – poor carbohydrates, they always get picked on – and eating too few calories to fuel our daily needs and activities. The media tells us that we need to eat a certain number of calories per day to support weight loss (*ahem* 800-1000 calories which is similar to what a child would need, not a full-grown adult), but this could not be further from the truth. While a reduction in calories may be needed to support weight loss, it is not the be all and end all. What is important to support weight loss is the quality of calories. A registered dietitian can help you understand how to make changes to the foods you are consuming, and promote foods that will help support weight loss and keep you full, as well as estimate the number of calories you may need (which is likely a lot more than 800-1000 calories). Eating an insufficient quantity of calories can actually harm your metabolism.

A weight loss program that promotes eliminating a food group is not going to be sustainable: what is important is the quantity you eat. At each meal aim for:

• ½ plate in vegetables and fruit
• ¼ plate in starches choosing whole grain and low glycemic index carbohydrates that are full of fibre to keep you full
• ¼ plate in lean proteins, including plant-based proteins more often
• Small amounts of healthy fats

Start your weight loss journey by reflecting on how your meals compare to this list. Weight loss should not be an all-or-nothing approach to food groups.

1. Weighing yourself daily and aiming for a magical number on the scale
   Your weight can fluctuate day-to-day because of many factors.  Hydration, what you eat, hormones, and even your bowel movement frequency can and will vary what you see on the scale. If you are going to weigh yourself, limit it to once per week or once per month and choose the same time of day each time, like first thing in the morning. Losing 1-2 lbs per week is considered healthy and gradual weight loss. That being said, there are many changes you can notice that are not weight related, like how your clothes are fitting, or your energy levels.
   
2. Denying yourself the pleasures of your favourite foods
   Cauliflower does not need to be a substitute for mashed potatoes, rice, pizza crust or anything else that you think tastes good. You can still eat your favourite foods and lose weight. Remember food quality and quantity is important. Fad diets often cause us to become hyper-focused on foods until it controls our life and prevents us from enjoying our favourite meals. When thinking about sustainable and realistic weight loss, we want to develop healthy lifestyle habits. Try this: instead of having 4 slices of pizza with your family, maybe you reduce it to 2 slices and choose a pizza full of vegetables instead of deli meats, and add a side salad or chopped vegetables and dip to round out your meal. When you classify foods as bad or good and then eat a food you’ve called “bad”, you end up telling yourself that you are bad. At the end of the day, food is food, and no particular food is better or worse for you (within reason, don’t go drinking olive oil direct from the bottle): it is all about how we include it in moderation.

Nutrition and weight loss play a role in managing stress urinary incontinence as it reduces the pressure placed on your bladder. You are going to be more successful with weight loss if you think about your lifestyle and find something that fits your regular routine. If you need help strategizing meals that are nutritious and delicious, and can help keep you full while supporting weight changes, working with a registered dietitian can be a great starting point and can provide ongoing support.

Emily Campbell is a registered dietitian and certified diabetes educator with a Master of Science in Foods and Nutrition. With years of nutrition experience, Emily is passionate about supporting individuals to make healthy eating delicious, nutritious, and easy to understand. Nutrition is complex, but Emily helps to break it down into easy-to-digest concepts to help individuals make sustainable nutrition changes that work with their preferences and lifestyle. Follow Emily here for more nutrition topics:

Instagram: @kidneynutrition

Website: emilykidneynutrition.com

References:

1. “FAQ’s,” The Canadian Continence Foundation, last modified 2021, accessed May 8, 2021 https://www.canadiancontinence.ca/EN/frequently-asked-questions.php
2. Emily L Whitcomb, Leslee L Subak, “Effect of weight loss on urinary incontinence in women,” Open Acess J Urol 3 (2011): 123-132, doi: 10.2147/OAJU.S21091
3. Rena R. Wing, et al., “Effect of Weight Loss on Urinary Incontinence in Overweight and Obese Women: Result of 12 and 18 Months,” Adult Urology 184, 3 (2010): 1005-1010, doi: 10.1016/j.juro.2010.05.031