Does Tubal Ligation Cause Weight Gain?
No, tubal ligation does not cause weight gain. Surgical sterilization, including tubal ligation, is classified as a weight-neutral contraceptive method.
Evidence from Guidelines
The most authoritative evidence comes from obesity and contraception guidelines that specifically categorize contraceptive methods by their weight effects:
Tubal ligation is explicitly listed as a weight-neutral method in the 2017 Gastroenterology obesity guidelines, appearing in the same category as barrier methods and intrauterine devices 1.
The American College of Obstetricians and Gynecologists confirms that surgical sterilization methods, including tubal ligation and hysteroscopic sterilization, are weight-neutral 2.
For women concerned about weight gain from contraception, copper IUDs, barrier methods, and surgical sterilization (including tubal ligation) are recommended as the most weight-neutral options 3, 2.
Hormonal Evidence
Research directly examining hormonal changes after tubal ligation supports the weight-neutral classification:
A 4-year prospective study of 306 women found that tubal ligation does not affect sex hormone levels during the perimenopausal period compared to women without tubal ligation, after adjusting for age, race, BMI, education, and parity 4.
Women with tubal ligation had similar hormonal profiles throughout the study period as women without the procedure, which explains the absence of weight gain since hormonal changes are the primary mechanism by which contraceptives affect weight 4.
Clinical Context
The distinction between tubal ligation and hormonal contraceptives is critical:
Depot medroxyprogesterone acetate (DMPA) is the only contraceptive method consistently associated with weight gain, particularly in adolescents with obesity, with 21% of users gaining >5% body weight at 6 months 3.
Combined oral contraceptives, vaginal rings, and most IUDs are generally weight-neutral in most women 3.
Tubal ligation involves no hormonal mechanism that could affect metabolism, appetite, or body composition, unlike hormonal contraceptives 1, 2.
Common Pitfalls to Avoid
Do not confuse correlation with causation: Women often undergo tubal ligation after completing childbearing, which coincides with age-related metabolic changes and natural weight gain that occurs in the general female population 2.
Avoid attributing normal age-related weight changes to the procedure: The timing of tubal ligation (typically in the 30s-40s) overlaps with perimenopause and decreased metabolic rate, which are independent causes of weight gain 4.
Recognize that any perceived weight gain after tubal ligation reflects population trends, not a procedural effect, as women who undergo tubal ligation gain weight at the same rate as the average female population 2.