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Can Birth Control Make You Gain Weight?

Do you feel like you are gaining weight from your birth control?  Maybe you have heard that birth control can make you gain weight or you are seeing the actual effects of birth control on your weight.  In this article we look at what some of the research says about birth control and its effect on your weight, your metabolism. etc.  

 

If you want to know if birth control can make you gain weight, keep reading. 

Research on Birth control and Weight Gain

Many studies have looked at the role of birth control and oral contraceptives in trying to answer many different questions around their role in human health.  The results are somewhat inconclusive but there are some suggestions on what might be going on.  The problem with looking at these studies is we already know the efficacy of birth control pills and oral contraceptives.  So having someone take a placebo is a bit unethical or controversial in terms of preventing pregnancy.   That being said, there is some research to look at around this topic.  However, there are limited placebo controlled trials. 

One study in particular found that weight gain does occur and it's more likely to be to be fat based and not water based weight gain.   Another study looked at the use of low dose oral contraceptives and found it was not associated with an impact on weight body composition or fat distribution.  In other words those that took the BCT did not have a change in their distribution of fat.  However they did find that when weight gain did occur, it was due to increase in body fat and not body water. These two studies agree about the weight gain, if and when it occurs, being fat not water based. 

A Cochrane review looking at birth control and weight gain states that the overall studies available for the review were weak.  However, they found there was a clear increase in weight over time equivalent to about four pounds per year.  This is a lot if you start to add that up.  Some studies actually contradict the first one (noted above), stating that the weight gain was more water weight related.  This makes sense given the role of estrogen (and hormones in general) with water retention.  When looking at weight gain in a shorter term horizon, it likely is water weight.   Likely there is a little bit of all this going on.  Because many of the studies are small, they are more subject to individual susceptibility too.  The Cochrane review was looking at several different studies combine them together giving it a broader applicability. 

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How Birth Control Can Make You Gain Weight

Looking a little bit deeper at this problem, overall there does seem to be a theoretical role for the influence of birth control on metabolism and an increase in weight too.  This study did a comprehensive look at different metabolic profiles in women taking birth control.   They looked at women using combined oral contraceptive pills or POCP (progestin only contraceptive pills).  They compared these women to women who didn't use any hormone contraception and specifically looked at their metabolic profiles.  They followed them for six years to uncover the metabolic effects.  There were eight hundred sixty nine that either started the oral contraceptives, stopped, or persistently used them.

What they found was the use of combined oral contraceptives  (synthetic estrogens and progestins which are synthetic progesterones) caused widespread metabolic inflammatory effects.  The persistent use does not appear to accumulate the effects over time.  They also found that the metabolic changes are reversed once they are discontinued and that progestins only didn't seem to have the same metabolic and inflammatory effects.   This last part about progestins is opposite to what the Cochrane review found.  The Cochrane review stated that the progestin only do seem to increase weight.  So there seems to be some conflict on which oral contraceptives or hormones in the oral contraceptives are responsible for the weight gain.  Regardless many studies do find that there is either a metabolic change, like decreasing insulin sensitivity or just an overall weight gain, in general.   This last study clearly found those taking oral contraceptives increased insulin, fasting triglycerides, and other things that are associated with insulin resistance.

Taken together both synthetic estrogen and progestins have the potential to cause weight gain.  Most of it is likely based on decreasing insulin sensitivity.  It is through this mechanism that the weight gain is occurring.  Based on your unique susceptibility, you may or may not have this issue with birth control.  If you have diabetes in your family or you are just more prone to that for other reasons, you are going to be more susceptible to gaining weight on birth control.  Remember that decreased insulin sensitivity is something that happens as you age anyways.  All of us are susceptible to it.  It is a phenomenon of being human but it does take years to manifest itself.  Depending on how long the studies are, they may not actually capture this susceptibility to gaining weight.  This also means that if you're younger, you may not be as susceptible to this increased weight as well.  Some people have this going on in their bodies already and they don't even know it.   This is because they're not getting the proper tests to be able to capture what is truly going on.  Insulin resistance is not always clear from fasting glucose or hemoglobin A1C alone. 

What Is Insulin Resistance

The way I look at the research is some people are going to be more susceptible to weight gain from birth control.   Some people are inherently more sensitive to insulin sensitivity and therefore going to be more susceptible to gaining weight on birth control.  If you already have diabetes, pre-diabetes, problems with insulin levels, blood sugar, PCOS, etc, it will make reversing any weight gain more difficult.  This does not make loosing weight impossible, just harder overall.  Keep in mind, there are many different types of birth control pills out there and ways to prevent pregnancy.  It's likely that not all of them are going to carry the same amount of risk for this problem of weight gain and insulin sensitivity.  Be sure to get as much information as possible to make an informed decision.  Ask your doctor what the best option is for you and your unique situation. 

 

That should give you a better understanding of can birth control make you gain weight.  If you have questions about the content in this article, please ask it in the comment section below.

If you want a customized plan on your hormones and weight gain due to birth control or otherwise, click in the link below to get started. 

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