Healthy and Active

2014

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medical Q&A Q A Should I participate in a medical weight-loss trial online? A clinical trial is a health-related research study. Sometimes they are "observational," meaning researchers observe participants and measure outcomes. Other clinical trials are "interventional" studies, in which some participants might receive medication or treatment and their outcomes are compared to those participants who did not receive treatment or who received a placebo (a pill, liquid or powder that does not contain medicine). All clinical trials have guidelines for who may participate, depending on what is being studied, to produce reliable results. Participating in a clinical trial may help you become more engaged in your health, and you might gain access to new treatments before they are widely available. You could obtain expert care at leading healthcare facilities during the trial, and you could help others by making a contribution to medical research. That said, ideally when you receive medication or treatment, you should have confi- Q A PHOTO COURTESY of canadian obesity network Answers by Nick Yphantides, MD, MPH Always talk to your trusted healthcare provider, who knows your medical history and your concerns, before signing up for a clinical weight-loss trial. dence that it's been proved to work. With weight loss, it is easy to make claims, but a treatment may not be valuable without research and data to back it up. Even worse, a treatment could cause more harm than good. Credible studies are sponsored by academic medical institutions, established pharmaceutical companies, the federal government, etc. Beware of commercials inviting you to join a research study but which are actually trying to sell you something. Before signing up for a clinical trial, always discuss it with your trusted healthcare provider. I'm a woman, and my doctor suggested that my obesity is causing urinary incontinence. Will this improve as I lose weight, and what can I do in the meantime? Urinary incontinence affects millions of women in the U.S. For obese and overweight women, losing weight can dramatically reduce both the episodes and severity of incontinence, according to several research studies in the New England Journal of Medicine and elsewhere. When we lose weight, we decrease the risk for developing type 2 diabetes and high blood pressure, improve control of already high blood pressure, reduce cholesterol levels— and, yes, decrease urinary incontinence. Of course, incontinence has many causes, and anyone who experiences troublesome incontinence should have a medical eval- uation. Depending on the exact type and severity of the problem, various treatment options are available, which we cannot cover completely here. Excluding more serious causes, your incontinence may be due to insufficient strength of the muscles in your pelvic region, which the pressure of extra weight in your midsection could be making worse. So what to do in the meantime? I suggest Kegel exercises to strengthen pelvic floor muscles, which can reduce urinary leakage and incontinence. You can find instructions for Kegel exercises online or through your medical provider. n HEALTHY & ACTIVE 2014 9

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