Many women avoid taking birth control because they are afraid of gaining weight. However, is there a true link between birth control pills and weight gain?
Research says it is not such a black or white link. Learn the truth about how birth control can affect weight gain and the ability to lose weight.
Different Types of Birth Control
Also referred to as oral contraceptives or "the pill," birth control pills provide protection against pregnancy by stopping ovulation and thus, the release of an egg. The active ingredients in birth control pills are synthetic versions of the female hormones progesterone and estrogen.
Some pills include a combination of the two hormones, but others only supply progestin – the synthetic version of progesterone. This latter type of pill, also known as a mini-pill, is useful for females who cannot take estrogen for any reason.
Note that hormonal types of birth control are also beneficial in reducing and/or preventing acne, osteoporosis, endometrial and ovarian cancers, and iron-deficiency anemia among other conditions.
While the pill's purpose often outweighs the cons, some can cause side effects such as:
• Nausea and vomiting
• Headaches and increased trouble focusing
• Heavier flows
• More and worse cramps
• Water retention and weight gain
• Acne and other skin irritations
• Increased depression, anxiety, or mood swings
• Spotting in between cycles and/or vaginal discharge
• Breast tenderness
In addition to the hormonal combination and mini pills, shots, patches, rings, implants, and IUDs are available birth control options.
A birth control shot requires an injection of the hormone progestin every 90 days in a doctor's office. Users of this type have reported less menstrual pain, reduced cramps, and lower menstrual flow.
However, others have reported nausea, headaches, dizziness, depression, and weight gain.
Rings also contain progesterone and estrogen hormones and therefore stop ovulation. Typically, a ring is inserted for three weeks, removed for the week of the menstrual cycle, and then a new one is reinserted.
Headaches and breast tenderness are the most commonly reported side effects.
The patch versions of birth control are usually placed on the upper arm, butt, or back. It secretes estrogen and progesterone into the body to stop ovulation. A new patch is applied every three weeks and removed for the menstrual cycle week just like the ring.
Common side effects are nausea, headaches, breast tenderness, and skin irritations.
Implants are known as lower maintenance, long-term options for birth control. An implant is a plastic rod that is implanted under the skin to release progestin, blocking ovulation and thus, pregnancy. It can last up to three years or be removed at any time.
The main reported symptoms are acne, breast tenderness, and weight gain.
Hormonal intrauterine devices (IUDs) are inserted into the uterus by a doctor and release a small amount of progestin, which blocks ovulation for 3 to 7 years at a time. The progestin in IUDs only circulates in the genital region, unlike that of typical birth control pills, and at a much lower amount.
Hormonal IUDs can cause loss of menstruation altogether and/or make them much lighter.
Copper IUDs are small t-shaped instruments that are placed in the uterus. They are non-hormonal, meaning they do not secrete estrogen or progesterone, and instead block pregnancy by deterring sperm. Sperm dislike copper and literally swim in the other direction if they encounter it. They can last up to 12 years, but can also be removed at any time with fewer complications trying to get pregnant.
The most common side effects include spotting between cycles, more and worse cramps, and heavier flows.
Does Birth Control Make You Gain Weight?
Of all the potential side effects of birth control and contraceptive methods, most women report being most afraid of gaining weight. Regardless of what that says about our culture, there is a common stigma that taking birth control equals inevitable and immediate weight gain. But research does not necessarily point to this.
Flashing back to the very first marketed birth control pills, which contained much higher amounts of estrogen and progesterone than today, weight gain could have been a higher risk. Increased concentrations of circulating progesterone can increase appetite and estrogen can cause fluid retention, so it is plausible that they did indeed lead to some weight gain.
Nonetheless, modern research reveals that weight gain associated with birth control is truly marginal, if not unlikely. This is simply because the levels of hormones in modern birth control options are not high enough to cause meaningful weight changes. In fact, the hormone levels are nearly three times less than before.
To reiterate, the only known ways birth control may increase weight are related to estrogen causing increased fluid retention and progesterone increasing appetite. Unsurprisingly, females with normal menstrual cycles that do not take hormonal birth control still experience fluid retention that correlates with higher estrogen levels and generally experience increased appetite when progesterone surges.
Which Birth Control Might Impact Weight the Least?
Everything in mind, taking a non-hormonal form of birth control like the copper IUD might pose the least risk of weight gain. That does not mean it has the least total amount of side effects, though.
On the other hand, the combination pills, patches, and others probably have the highest risk of potential weight gain because they contain both the hormones estrogen and progesterone. The progesterone-only pills likely fall in between non-hormonal and combination types since they only include one hormone.
Furthermore, if any weight gain is experienced, it is usually within the first couple of weeks or months of taking it as the body adjusts. Allow time for your body to adapt before immediately blaming weight gain on the pill.
However, if rapidly gaining body weight or gaining more than 4 to 5 pounds, it is wise to consult with a dietitian and doctor. They can help determine other potential factors of weight gain and whether another birth control option would be better.
How to Lose Weight on Birth Control
Losing weight while on birth control is possible through healthy habits concerning diet, exercise, sleep and stress management. The other good news is that the recommendations are no different for someone not taking birth control.
Consume a Balanced Diet
A balanced diet aims to balance blood sugar and maintain insulin sensitivity and incorporates plenty of whole, real foods including:
• 5 to 9 servings of colorful fruits and veggies per day (fiber)
• Lean protein like chicken, fish, eggs, beans, legumes, and tofu
• Healthy fats like fatty fish, nuts, seeds, avocados, and olive oil
• Some whole grains like brown rice, whole-wheat pasta and breads, quinoa, and barley
An easy way to ensure a balanced diet and portioned plate is to fill half a plate with veggies and/or fruits, and then add a palmfull of protein, a tablespoon or two of healthy fats, and sometimes a small serving of a whole grain.
Achieve best results by largely limiting highly processed foods. Enjoy indulgences like cookies, ice cream, and donuts on occasion.
Although diet affects weight loss efforts most, exercise can accelerate efforts while also improving mental and emotional health.
The American Heart Association proposes that adults achieve a minimum of 150 minutes of moderate aerobic activity or 75 minutes of vigorous exercise per week. Aerobic activity, also known as cardio, burns a substantial amount of calories while being performed, which helps balance overall caloric intake.
However, it is also important to perform strength training two to three times a week to build muscle mass, which burns more calories at rest. To get the most bang for a buck, focus on the major muscle groups like the back, chest, legs, and shoulders.
Manage Stress Well
Stress is often a silent culprit of weight gain because it can lead to chronically elevated cortisol. The hormone can cause water retention, increase cravings for high sugar and fat foods, and diminish insulin response that promotes fat storage.
Chronic stress can also lead someone to emotionally eat more than usual for a period of time which can lead to weight gain.
Some stress-relieving strategies include meditation, yoga, therapy, dancing, reading, calling a friend, listening to music, taking a warm shower, drinking a calming cup of tea, and journaling.
Get Adequate Sleep
Getting seven to nine hours of sleep is ideal, but getting quality sleep is even more important and helps deter the risks of weight gain. Quality sleep can be defined as falling asleep easily, staying asleep for most of the night, and waking up feeling rested.
If struggling to obtain quality sleep, try the following:
• Go to bed and wake up at the same time regularly
• Avoid caffeine up to eight hours before bedtime
• Create a wind-down nighttime routine
• Avoid electronics, TV, and other blue light two hours before bedtime
• Choose a supportive, comfortable bed
• Sleep in a cool temperature and dark room
The Final Word on Birth Control & Weight
Weight gain is a common worry of many women taking birth control. While birth control can impact weight to a degree, gaining true body fat is not as actually significant and common as believed.
The impact of birth control and weight gain can also depend on the type of contraceptive taken.
Some birth control pills might fluctuate weight due to fluid retention, while others might spike appetite that can cause overeating and subsequent weight gain.
If experiencing significant weight gain while taking birth control, consulting with a doctor is wise. Adopting healthier lifestyle habits can help offset the side effects of birth control as well.
Contraception: Do Hormonal Contraceptives Cause Weight Gain? U.S. National Library of Medicine. Published June 29, 2017. https://www.ncbi.nlm.nih.gov/books/NBK441582/.
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Kassel G. How to Figure out Which Birth Control Method Is Right for You. Healthline. Updated August 30, 2020. https://www.healthline.com/health/birth-control/methods#use-as-needed.
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