Weight gain and bladder symptoms as we age…why?

By: Anna Myers, MSN, WHNP-BC, FNP-BC, CUNP, RN

Many of our patients describe that as they have gotten older, not only are they experiencing more bladder symptoms but also a tough time with weight gain.  It is well established that increased weight gain correlates to increased urinary incontinence. Increased weight puts extra strain on the muscles and nerves of the pelvic floor.  Also, abdominal weight gain increases abdominal pressure and in turn bladder pressure and mobility of the urethra. But what’s a girl to do? Oh boy, is this a mixed bag of tricks. The research is all over the place on why we gain weight as we age but there are some common themes to think about...

  • We can’t eat the same amount of calories we once did as our bodies need approximately 200 less calories per day at age 50, and 400-500 less calories by age 65-70.
  • We tend to not be as physically active, so we don’t burn as many calories as we once did.  We need to get out and walk or run with the dog, walk or bicycle to a friends house instead of driving, get up from our chair and move around.
  • We lose lean muscle mass not being active as we age and that means 20-25% of our metabolism is slowed down by having fat instead of muscle ~ less calories burned!
  • We don’t get enough sleep.  This is a common understanding but the reasoning is debatable...one thought is that during sleep is when our body repairs and rebuilds muscle, which is important as we discussed in the previous point.
  • Anxiety is an evil culprit.  You’ve likely heard about cortisol, nicknamed the “stress hormone”.  Although cortisol, the hormone that is secreted when we are in fight or flight mode can be helpful, it can also contribute to difficulty losing weight if we do not manage our stress.  Cortisol stimulates fat and carbohydrate metabolism for energy and stimulates insulin release and maintenance of blood glucose. This causes increased appetite and the craving for sweet, high fat and high salt foods.  Elevated cortisol in the body causes us to produce less testosterone, so less lean muscle, therefore few calories burned. There has been research that shows being taught techniques to de-stress may be more helpful than nutrition education.  Aside from the all the physiology of cortisol, stress contributes to skipping workouts, emotional eating and not getting enough sleep, what a vicious cycle!

So what’s the answer...we’re all looking for the magic bullet but until then, work on increasing physical activity and muscle mass. These are small gains but everything counts.  Less treats, decreased portion sizes, only vegetables if you take seconds will help on that front. Less alcohol (lots of calories)! Lastly but maybe most importantly, work on that anxiety and stress!  

I hope you learned about a few things about weight gain and bladder symptoms as we age.  If you have any questions or desire to further discuss your urological concerns, please call our office at (440) 202-1515.  Thank you!

Anna Myers is a women’s health, urology and family board certified nurse practitioner working in our office here in Richfield, Ohio.