DMPA users whose weight increased by 5 percent within the first six months of use, called “early gainers,” are at risk of continued, excessive weight gain. While 75 percent of users gained little or no weight, the early gainers averaged weight gain of 24 pounds over three years.

The researchers recommend that physicians tailor counseling based on women’s risk factors, closely monitor weight at each three-month follow-up visit and suggest a different contraception method to patients who gain significant weight within the first six months of use.

Researchers found that early gainers exhibited three major risk factors: A body mass index under 30, having children before starting DMPA and a self-reported increase in appetite after six months of DMPA use.

The study, which appears in the August issue of Obstetrics and Gynecology, followed 240 women ages 16-33 who used DMPA for up to three years. Researchers looked at several potential predictors of weight gain, including age, race, baseline obesity prior to DMPA use, lifestyle variables such as smoking and exercise level, and weight gain at six months. They found that those who had gained more than 5 percent of their body weight within six months, or after just two injections of DMPA, continued to gain significant weight during the next 30 months.

While previous studies have associated birth control-related weight gain with a higher BMI, Berenson’s study suggests that a lower BMI – under 30 – is more predictive.

The biological mechanism of DMPA-related weight gain is still unknown, but researchers note that possible mechanisms include glucocorticoid-like activity, how the body breaks down simple carbohydrates such as glucose, and DMPA-associated interference with insulin action. Previous findings seem to argue against the theory that weight gain could be due to the drug’s perceived effects on increased caloric intake and decreased energy expenditure, but ongoing research is needed to confirm or discount varying possible explanations.

DMPA is an injected contraceptive administered to patients every three months. According to the American College of Obstetricians and Gynecologists, more than 2 million American women use DMPA, including approximately 400,000 teens. DMPA is relatively inexpensive compared with some other forms of birth control, has a low failure rate and doesn’t need to be administered daily, which contributes to the contraceptive’s popularity.

This study builds upon UTMB research released earlier this year that found DMPA users gain significant weight not seen among women using oral or nonhormonal contraception. The study was supported by the National Institute of Child Health and Human Development. Yen-Chi L. Le, of UTMB’s department of obstetrics and gynecology, and Mahbubur Rahman, of UTMB’s Center for Interdisciplinary Research in Women’s Health, contributed to this research.

For more information, visit medicainnewstoday.com.

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Depot medroxyprogesterone acetate (DMPA), most commonly known as the birth control shot, is an injected form of birth control that is being administered to patients every three months. More than 2 million women in the United States, which includes almost 400,000 teenage girls, prefer this contraceptive method. The popularity of DMPA can be explained by its lower costs compared to other birth control forms, as well as by its low failure rates and the fact that there is no need to use it on a daily basis.

However, the scientists found that women who have been using DMPA, gained an average of extra 11 pounds and increased their body fat by 3.4 per cent over the three-year period of time, compared to those women who were taking oral contraceptives or used non-hormonal methods of birth control, the researchers at the University of Texas Medical Branch said. They strongly recommend that patients and their physicians should consider this new information when making a decision about choosing the most suitable form of contraception.

According to Dr. Abbey Berenson, professor in the Department of Obstetrics and Gynecology and director of the Center for Interdisciplinary Research in Women’s Health at UTMB, and a main author of the research, the link between DMPA and an increased belly fat, which is a known risk factor for metabolic syndrome, leads to such conditions like cardiovascular disease, diabetes and stroke.

The scientists based their findings on the study that tracked 703 women in two age categories: 16 to 24 years, and 25 to 33 years, who were using DMPA, oral (desogestrel) or non-hormonal (bilateral tubal ligation, condom or abstinence) contraception for three years. Women who initially chose DMPA, but later stopped using this method and selected another form of contraception, were followed for about 2 more years. Throughout the whole duration of the experiment, the experts were recording any changes in the women’s body weight and composition. Such factors as age, race, diet and exercise have been taken into consideration.

When later results of all the three groups were compared, it became clear that women who were using DMPA, were more than twice as likely to become obese over the period of three years, compared to users of oral or non-hormonal forms of birth control. However, the study found that the body fat of women who had used birth control methods other than DMPA, slightly increased while their lean body mass (muscle) went down. Researchers said this did not happen among the women who exercised on a regular basis and ate a healthy diet with high levels of proteins.

In Dr. Berenson’s opinion, it is not clear yet as to why DMPA causes an increase in weight gain and body fat, and no link has been established between the use of DMPA and calories in a diet, fat consumption or amount of physical activity on body mass changes. The findings seem to contradict the existing theory that gaining weight could be happening due to the drug’s perceived effects on an increased consumption of high-caloric diet and less physical activity, and the current research still continues its investigation in order to confirm or discount many possible explanations on this matter, the expert concluded.

The study was supported by the National Institute of Child Health & Human Development.

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2. Watch Water Intake
One of the ways you can control weight gain caused by birth-control pills is by monitoring your water intake. You should drink at least eight glasses of water a day to stay healthy, whether or not you’re taking birth-control pills. If you’re well-hydrated, your body is less likely to retain water. Stick to plain water instead of sugary or caffeinated drinks. The excess sugar adds carbohydrates to your diet and the caffeine can leave you feeling drained.

3. Feel Good With Fiber
You can control your weight while taking birth-control pills by keeping yourself regular and balanced. A healthy fiber intake is an effective way to clean out your colon, get regular and help you lose excess weight. Include whole grains and high-fiber cereals in your daily diet. If you don’t have time to make sure you’re eating enough foods with fiber, try taking a daily fiber supplement to keep your weight under control and keep everything moving the way it should.

4. Eat Right to Feel Right
Maintaining a healthy, balanced diet is one of the easiest ways to control your weight while on birth-control pills. If you resort to eating junk food and make unhealthy choices, you’re going to gain weight. If you add this behavior to the weight you’re already gaining due to the pills, your problems will just compound themselves. Stick to a balanced diet, including plenty of lean meats, fresh fruits and vegetables, healthy dairy and whole grains. Keeping your diet balanced will keep your weight in check and help you feel better, too.

5. Work It Out
No matter the cause of your weight gain, exercise is a great way to fight it. Weight gain from birth-control pills is no exception, so find yourself a healthy exercise regimen and stick to it. Take nightly walks around the block, go for morning bike rides before work or invest in an elliptical machine in order to work out at home. If you don’t feel motivated on your own, join a gym on a trial membership to get some training from a professional and lose that weight the healthy way.

For more information, visit Livestrong.com.

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Moreover, most of the recent studies on lower estrogen hormone based pills (30 mcgm or less) have shown weight loss or no change, if continued to take for a year.

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The recent studies taken on low-dose (low estrogen) pills have indicated the nominal change in the weight. Weight gain while taking pills could be possible in few but not necessarily be at alarming situation. If the weight gain is due to pills then it could be a temporary phenomena and certainly not permanent. Analysts have pointed out that 5-10% women adding few pounds while they are taking birth control pills but there is similar number of women who are gaining weight but not on pills at all. Weight gain could be due to fluid retention in the body (occurs other than the pills) and fat deposition. Some women may be sensitive to either of these and experience weight gain regardless of birth control pills.

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1. Step 1
Speak with your gynecologist about any concerns you may have about weight gain. Your doctor can evaluate your current health status and inform you of the best ways to control weight gain while using birth control. As part of the evaluation process, your doctor may take a sample of your blood and urine and send it to the lab for testing.

2. Step 2
Choose birth control with a lower estrogen level such as Ortho Tri-, Triphasil, Yasmin, Levlite, LoEstrin and Alesse. Research shows that high doses of estrogen can result in fluid retention and weight gain.

3. Step 3
Follow a well-balanced diet. Be sure to eat three healthy meals a day (breakfast, lunch and dinner), eat plenty of fruits and vegetables and reduce your sodium (salt) intake. Avoid eating foods that are high in sugar and carbohydrates (such as candy, french fries, soda, ice cream and potato chips) and choose foods that are less fattening.

4. Step 4
Exercise 4 to 5 times a week. You need some form of physical activity in order to stay healthy and fit. Some effective exercising methods include walking, jogging, swimming, aerobics, biking, tennis and kick boxing.

5. Step 5
Drink plenty of water every day. You should drink at least 6 to 8 glasses of water a day. Water helps to flush out your system and it also reduces weight gain.

6. Step 6
Take fluid pills to reduce water retention in your body. Your doctor can prescribe fluid pills or she may recommend over-the-counter pills.

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Last year, a group of researchers carried out what may be the most extensive study on the subject to date. Their conclusion: In most women, neither the pill nor the patch seems to add any pounds at all.
Of 44 previous studies that the researchers combined and analyzed, 3 found no difference between women who took hormonal contraceptives and those who took a placebo. The other studies looked at women taking different types and doses of hormonal contraception, and came to the same overall conclusion.

The claim may have had some truth many years ago, when the pill contained high levels of estrogen, which can cause water retention and increased appetite. Nowadays, most versions of the pill have only half the amount found in early versions.

Some studies have shown that while the pill may add a couple of pounds at first from water retention, the added weight disappears as the body adjusts to the hormones.

Another factor has nothing to do with the pill: most women start birth control as teenagers and continue it through their 20s, a period when women naturally tend to gain weight.

THE BOTTOM LINE
The link between the pill and weight gain is exaggerated at best.

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Some progestin-dominant pills can cause appetite increase and permanent weight gain. Pill-related depression may also lead to increased appetite and weight gain. Have you noticed a dip in your mood lately or more frequent snack cravings? If you feel bothered by some of these side effects, your health care provider can prescribe a different brand of pills or recommend another method of birth control.

On the other hand, there are many reasons why women gain weight that are not pill-related. For example, are there small changes in your diet that you may not have noticed, like snacking at work or having more drinks on the weekends with friends? Does your excerise routine include weight lifting? Increased muscle mass may explain some of those extra pounds. Talk with your health care provider about the extra weight you’ve gained, and, together, you may be able to find the cause.

Taking birth control certainly has pros and cons, but the idea that the pill causes women to gain weight is mostly a myth. Before ditching the pill, try talking with your health care provider about your birth control options and other explanations for your weight gain.

For more information, visit Goaskalice.columbia.edu.

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