From the Guidelines
For a 28-year-old female on Nexplanon, the most effective weight loss strategy is to create a modest calorie deficit of 300-500 calories daily through portion control and increase physical activity to 230 minutes of moderate exercise on most days, as recommended by the most recent guidelines 1. To achieve this, consider the following:
- Focus on creating a calorie deficit through a balanced diet with an intake of 1200-1500 kcal/d for women, as suggested by the 2013 AHA/ACC/TOS guideline 1.
- Incorporate strength training 2-3 times weekly to preserve lean mass during weight loss, as recommended by the 2023 JAMA review 1.
- Track food intake using an app for 1-2 weeks to identify hidden calories and incorporate more protein (aim for 0.8-1g per pound of body weight) and fiber-rich foods to increase satiety.
- Stay well-hydrated with at least 2 liters of water daily, as thirst can be mistaken for hunger.
- Consider intermittent fasting approaches like 16:8 (16 hours fasting, 8-hour eating window) if it fits your lifestyle.
- If after 3 months of consistent effort you see minimal results, consult your healthcare provider about alternative contraceptive options, as hormonal contraceptives affect metabolism differently among individuals. Key points to remember:
- Sustainable weight loss typically occurs at 1-2 pounds per week.
- Nexplanon's hormonal effects may make progress slower but not impossible.
- Physical activity is essential for weight maintenance and cardiometabolic health, with recommendations of 150-300 min/wk of moderate or 75-150 min/wk of vigorous physical activity, as well as resistance training 2-3 times a week 1.
From the Research
Weight Loss Recommendations
For a 28-year-old female on Nexplanon (etonogestrel implant) who is already working out regularly and has a good diet, the following points should be considered:
- The etonogestrel implant has been shown to be highly effective for contraception, with zero pregnancies documented in a study of 237 implant users over 229.4 women-years of follow-up 2.
- However, the implant has been associated with weight gain, with a significant mean weight increase of 3.0 kg over 36 months of use, compared to 1.1 kg for intrauterine device (IUD) users 3.
- The weight gain associated with the etonogestrel implant may be influenced by genetic variants, such as the NR1I2(PXR) rs2461817, PGR rs537681, and CYP3A7*1C variants, which have been shown to affect steady-state etonogestrel concentrations 4.
- To minimize weight gain, it is recommended to maintain a healthy diet and regular exercise routine, as well as monitor weight and body mass index (BMI) regularly.
- It is also important to note that improper insertion technique may increase the risk of implant migration, which can lead to complications such as pain, discomfort, and dyspnea 5.
- Interactions between the etonogestrel implant and certain antiretroviral regimens, such as efavirenz, may also affect etonogestrel concentrations and increase the risk of weight gain 6.
Key Considerations
- Regular monitoring of weight and BMI
- Maintenance of a healthy diet and regular exercise routine
- Proper insertion technique to minimize risk of implant migration
- Consideration of potential interactions with antiretroviral regimens
- Genetic variants may influence steady-state etonogestrel concentrations and weight gain.