Birth Control - Weight Gain

Weight gain is a common complaint of women taking birth control pills. But research shows that most women gain little, if any weight because of the birth control pills. In general, the number of women on the pill who gain weight is equal to the number of women who lose weight. But for some women, this can be a factor in gaining weight.

The combination of hormones (estrogens and progestins) found in some birth control pills can lead to weight gain. These hormones can cause fluid retention, increased body fat, and a bigger appetite in some women. Changes in eating habits, lack of exercise, and some medical conditions can also affect body weight whether or not you take birth control pills.

Some birth control pills are less likely to cause weight gain. If you’re worried about gaining weight, remember to cut back on calories and get more exercise. Talk to your health care provider about switching to another birth control pill if you think it’s possible that your pill is causing weight gain.

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Women often blame the birth control pill for weight gain. But studies have shown that the effect of the birth control pill on weight is small — if it exists at all.

However, the way the hormones in birth control pills act on tissues in your breasts, hips and thighs can make you feel as if you’ve gained weight. This is usually due to fluid retention and not increased body mass or fat. Estrogen in birth control pills directly affects fat (adipose) cells, making them larger, but not greater in number.

In very rare circumstances women may add muscle, which can add weight, when taking the pill. This is due to the slight male-sex-hormone effect that the pill may have on some women.

But no matter if pill-related weight gain is perceived or real, many women find this side effect undesirable. Taking pills with a low dose of estrogen may diminish these effects, but you may also experience a greater risk of spotting between periods.

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In one study of pills, a formulation containing desogestrel as the progestin and slightly less estrogen had significantly less weight gain when compared to a pill containing norethindrone (Ortho Novum 7/7/7®). This may imply that the specific progestin has a role in weight gain, possibly through a lesser degree of insulin resistance. Or it could be the combination of lower estrogen and the specific progestin but in any case, there was less weight gain. Currently marketed pills with desogestrel as the progestin are Desogen® and Ortho-Cept®.

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There have been reports through the years, especially with the older, higher dose pills, of adverse effects on insulin resistance. Even recent studies seem to indicate that current pills can raise insulin levels. Insulin resistance is a condition in which insulin levels rise in response to carbohydrates and drive all energy into the fat cells and essentially prevent weight loss even with dieting.

Not all women are susceptible to insulin resistance and thus not all women gain weight using oral contraceptives. Those that have a tendency to abnormal glucose metabolism, however may be the ones who gain weight. If a woman gains weight upon starting oral contraceptives and there are not other explanations, she should be checked out for possible insulin resistance.

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