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Alison J. Huang, MD; Leslee L. Subak, MD; Rena Wing, PhD; Delia Smith West, PhD; Alexandra L. Hernandez, MPH; Judy Macer, BSc; Deborah Grady, MD; for the Program to Reduce Incontinence by Diet and Exercise Investigators

Arch Intern Med. 2010;170(13):1161-1167. doi:10.1001/archinternmed.2010.162

Background  Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear.

Methods  Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors.

Results  Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89).

Conclusion  Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control.

Trial Registration  clinicaltrials.gov Identifier: NCT00091988

Author Affiliations: Departments of Medicine (Drs Huang and Grady and Ms Hernandez), Obstetrics, Gynecology, and Reproductive Sciences (Dr Subak and Ms Macer), Urology (Dr Subak), and Epidemiology and Biostatistics (Dr Subak), University of California, San Francisco; Veterans Affairs Medical Center, San Francisco (Drs Subak and Grady); Department of Psychiatry and Human Behavior, Warren Alpert Medical School at Brown University, Providence, Rhode Island (Dr Wing); and College of Public Health, University of Arkansas for Medical Sciences, Little Rock (Dr West).

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