Does birth control make you gain weight? Research is clear it does not

iStockResearchers have not found a link between most modern birth control methods and weight gain.
  • When oral contraceptives first came out in 1960, the amount of estrogen and progestin was much higher than it is today.
  • Since estrogen at higher doses can increase appetite and cause fluid retention, many women who took early forms of the pill gained weight as a result.
  • Not everyone responds to birth control in the same way. However, modern birth control contains lower levels of hormones and multiple studies have shown that it is not linked to weight gain.
  • That said, there is one birth control injection, Depo-Provera, which is highly effective but also linked to weight gain because it’s thought to trigger signals in the part of the brain that controls hunger.
  • This article was reviewed by Olivia P. Myrick, MD, who is a clinical assistant professor with the Department of Obstetrics and Gynecology at NYU Langone.
  • Visit Insider’s homepage for more stories.

If you’re concerned about gaining weight while on birth control, you’re not alone. Many women choose to avoid hormonal birth control methods or go off of them altogether because they believe the increase on the scale is a direct result of the method they’re using.

But most studies disagree. Here’s what you need to know about birth control and your weight.

Significant weight gain on birth control is unlikely

If you’re just starting birth control, you may gain a few pounds. But that extra weight most likely isn’t from fat, it’s from fluid retention – and it’s only temporary.

Turns out, researchers have found that estrogen is linked to fluid retention in women. So if you’re taking birth control that raises your estrogen levels, it could lead you to gain some water weight.

The good news is that as your body adjusts, the fullness you feel from any fluid retention typically subsides within two to three months and your weight should return to its starting point.

“Women on birth control pills should monitor their weight regularly, but keep in mind that most studies do not show significant weight gain,” says Felice Gersh, MD, an OB-GYN and founder and director of the Integrative Medical Group of Irvine.

For example, a 2014 meta-analysis in the Cochrane Library reviewed 49 trials of 52 different types of birth control and found no convincing link between weight gain and any of the types of birth control. Moreover, intrauterine devices and contraceptive implants are also not widely associated with weight gain, even though they still are hormonal forms of birth control.

That said, there is one birth control method linked to weight gain, but not in the way you might think.

Depo-Provera may cause weight gain

Depo-Provera is a progestin-only hormonal injection given four times a year, every three months, in order to suppress ovulation. It is a very effective form of contraception. But, according to Yale Medicine, it may also trigger signals in the part of the brain that controls hunger.

“In my experience, the injections of Depo-Provera are the worst offenders,” says Gersh. She says progestins are used to induce weight gain in the elderly and ill or frail people. “Synthetic progestins in high doses, as with Depo-Provera, alters metabolism in a negative way.”

Moreover, if you check out the FDA’s prescribing information for Depo-Provera, it lists weight gain as a possible side effect, especially with long-term use.

When administered every three months, the FDA says the average weight gain for a one-year treatment period was 5.4 pounds. After two years, the average gain totaled 8.1 pounds.

However, if healthy choices are made regarding eating habits while taking Depo-Provera, it still may be the right contraceptive medication for some women, and weight gain may not be an issue.

The fear of weight gain is decades old

When oral contraceptives first came out in 1960, the amount of estrogen and progestin was much higher than it is today.

For example, according to a 2012 review published in the journal Canadian Family Physician, the first marketed pill, Enovid 10, contained both forms of progestin and estrogen, like many birth control methods today. However, Enovid 10 had anywhere from 3 to 100 times more progestins and 3 to 7 times more estrogens than modern birth control methods.

Since estrogen at higher doses can increase appetite and cause fluid retention, many women who took Enovid 10 and other early forms of birth control gained weight as a result. But modern birth control has lower levels of hormones, so women on birth control today are less likely to gain weight from it.

Tips for managing your weight while on birth control

Maintaining your weight while on most forms of birth control is no different from when you weren’t taking birth control. So before you decide to toss your highly-effective birth control method, consider trying these tips for managing your weight.

  • Participate in 150 to 300 minutes a week of moderate-intensity aerobic exercise. Plus, two to three days of strength training, focusing on all the major muscle groups.
  • Stick to a diet that includes plenty of vegetables, fruit, lean protein, complex carbohydrates, and healthy fats. Plus, reduce the amount of added sugar and processed food.

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