Can oral contraceptive pills (OCPs) cause weight gain?

From the Guidelines

Birth control pills are not typically associated with significant weight gain for most users, with the majority of modern low-dose combination pills resulting in little to no weight change. When considering the potential impact of birth control pills on weight, it's essential to differentiate between various types of hormonal contraceptives. According to a study published in Gastroenterology 1, the weight impact of hormonal contraceptives can vary significantly due to differences in progestin and estrogen formulations. While some progestin-only contraceptives, like medroxyprogesterone acetate, have been linked to weight gain, combination oral contraceptive pills (containing both estrogen and progestin) generally show no clear evidence of weight change.

Key points to consider:

• Individual responses to hormonal contraceptives can vary significantly, with some women experiencing temporary water retention or slight increases in fat or muscle mass 1.
• The mechanism behind potential weight changes involves hormonal effects on appetite, fluid retention, and fat distribution rather than direct caloric increases.
• Certain formulations, such as pills containing drospirenone (like Yaz or Yasmin), may have less impact on weight, although individual results can differ.
• For women concerned about weight gain, discussing options with a healthcare provider can help identify the most suitable formulation or alternative contraceptive methods, such as barrier methods or intrauterine devices, which may be weight-neutral 1.

In terms of monitoring weight changes, a study published in MMWR Recommendations and Reports 1 suggests that assessing weight changes and counseling women who are concerned about weight changes perceived to be associated with their contraceptive method is crucial, particularly for users of injectable contraceptives like Depo-Provera. However, the primary concern regarding weight gain and birth control pills should be addressed on a case-by-case basis, taking into account the specific formulation and individual response. Ultimately, the decision to use birth control pills should be based on a comprehensive evaluation of the benefits and risks, with weight gain being just one of the factors to consider.

From the FDA Drug Label

Common adverse reactions (≥ 2% of users) were: ... increased weight (2.5%) The FDA drug label reports that increased weight is a common adverse reaction associated with the use of drospirenone and ethinyl estradiol tablets, occurring in 2.5% of users 2.

• Weight gain is a possible side effect of birth control pills. It is essential to note that the FDA drug label does not provide a comprehensive understanding of the relationship between birth control pills and weight gain, and individual experiences may vary.

From the Research

Weight Gain and Birth Control Pills

• The relationship between birth control pills and weight gain is a common concern, with some studies suggesting a potential link between the two 3, 4.
• A study published in 2009 found that weight gain is one of the side effects often attributed to the use of hormonal contraception, with weight fluctuating by about 3 kg over an observation interval from 6 to 24 months 3.
• However, another study published in 2011 found that a causal relationship between combination contraceptives and weight gain has not been established, and that available evidence was insufficient to determine the effect of combination contraceptives on weight 4.

Factors Influencing Weight Gain

• The type of contraceptive used may influence weight gain, with some studies suggesting that Depo Provera users may experience a higher increase in weight compared to other hormonal contraceptives 3.
• Age may also be a factor, with one study finding that age-associated weight gain is approximately 0.1 kg/m(2) annually, corresponding to about 300 g/year 3.
• Other factors, such as changes in diet and exercise, may also contribute to weight gain in women taking birth control pills.

Study Findings

• A study published in 2011 found that most comparisons of different combination contraceptives showed no substantial difference in weight, and that discontinuation of combination contraceptives due to weight change did not differ between groups 4.
• Another study published in 2009 found that users of intrauterine devices experienced a weight gain that was approximately double that of the average female population 3.
• However, it's worth noting that the evidence is not conclusive, and more research is needed to fully understand the relationship between birth control pills and weight gain 4.