Does birth control make you gain weight? All your questions answered

It’s an ongoing question: Does birth control make you gain weight? You might not have heard your doctor or sex education teacher say it, but somehow the myth prevails. So if you’ve found yourself wondering whether there’s a link between hormonal birth control and body weight, you’re certainly not the only one. 

The debate about hormonal birth control and weight gain has been around for almost as long as birth control itself, and it may have even shaped which birth control option you choose to use. For many people, it’s a topic that feels close to home. Your relationship with your body is such a personal one, which is why it’s so important that you feel supported and sure about the contraceptive method you opt for. 

But there’s a reason why you’ve never heard your doctor say birth control makes you gain weight: there’s no definitive medical link. So let’s get into it. Here’s everything you need to know about the science behind birth control and weight gain. 

Does birth control make you gain weight? 

Hands up if you’ve ever turned to the internet to ask if birth control and weight gain are linked. It’s a myth that’s spread like wildfire, and despite all your searching, it can often feel like there’s no clear answer.

“Because we live in a weight-conscious society where larger bodies are stigmatized, fear of gaining weight can be a very powerful and negative force for people,” says Dr. Jennifer Boyle, obstetrician and gynecologist, Massachusetts General Hospital, Massachusetts, US.

“Studies show that concern about weight gain can lead to stopping birth control even when people haven’t actually gained any weight. However, rigorous medical studies do not show any significant weight gain with hormonal contraception,” the expert adds. And that’s quite a staggering fact. 

One review looked at 49 studies that focused on whether weight gain could be linked to the combined pill (that’s the pill that contains both the hormones estrogen and progestin, the synthetic version of progesterone). It concluded that “no large effect is evident” but added (as many studies do) that there wasn’t enough research to be absolutely 100% sure of this.

Similar studies have looked into whether other methods, such as the progesterone-only pill and combined estrogen-progestin contraceptive patch, can cause weight gain. All conclusions pointed to the fact that there’s very limited evidence to suggest this is the case. 

So, if medical evidence says that birth control doesn’t make you gain weight, where has this myth come from? 

Why are birth control and weight gain linked? 

To understand why there’s still so much confusion surrounding birth control and weight gain, we need to dig into the history of contraception a little bit. Prepare to call yourself a birth control oracle. 

The first contraceptive pill was approved in the US by the Food and Drug Administration in 1960. It was introduced in Australia in 1961, the UK in 1967, and Canada in 1969. So, the pill isn’t actually that old. However, since it was first tested in the 1950s, it’s changed a lot. 

When it was first developed, the contraceptive pill included much higher levels of progesterone and estrogen. High levels of progesterone have been linked to an increase in appetite, while synthetic progestin and estrogen are a cause of fluid retention. These changes in water retention are generally really small if you’re younger and healthy, but it’s easy to see where the links between contraception and weight gain may have started. 

“Contraception certainly has evolved over the years,” explains Dr. Angela Jones, obstetrician and gynecologist, Jersey Shore University Medical Center, New Jersey, US. “[It] contains a fraction of the hormones in pills of the past. Hence, the side effects, such as weight gain, are much less.”

The hormone levels in the combined pill were amended to try to minimize these side effects. And as other birth control options have been developed (such as the contraceptive implant, injection, patch, hormonal and nonhormonal coil, and other birth control pills), we now know more about the side effects attached to each option. You can learn more about the different forms of contraception available by using an app like Flo. 

What types of birth control make you gain weight? 

People choose to take birth control for lots of different reasons. There’s no one-size-fits-all when it comes to contraception, and what’s a good fit for you won’t necessarily be the same for your friend. For example, you may opt for hormonal or nonhormonal protection. Similarly, if you don’t like the idea of taking a pill every day, you may choose a more long-acting contraceptive like the implant. 

You’ll always be presented with a list of side effects before starting a new contraceptive, and it’s usually a case of weighing what works best for you. But is weight gain featured on any of these lists? 

The best way to fully understand any side effects of birth control is to speak to your doctor before you switch up your contraception.

Of all the birth control methods available, there’s only one — a type of injection — that has been shown to be associated with weight gain. But, clarifies Dr. Boyle, those findings only emerged “in some, not all, medical studies.” The specific type of contraceptive injection included in these studies was depo-medroxyprogesterone acetate (DMPA), an injection that releases progestin into your bloodstream to prevent pregnancy. 

A 2019 study published in the American Journal of Obstetrics and Gynecology found that weight gain after using DMPA varied, with some people reporting to have gained up to 4 kilos. “The weight gain from DMPA seems to be greatest among younger, adolescent women who are at a higher baseline weight when they begin using it,” says Dr. Boyle. Other studies have looked at how people’s racial background and starting weight could have an impact. 

Birth control that doesn’t cause weight gain 

Aside from the DMPA injection, as we now know, research hasn’t found any conclusive evidence that other birth control methods cause weight gain. Based on the fact that the birth control pill has been linked to weight gain in the past, you might be curious if there’s any truth in it today.

“Generally speaking, no,” says Dr. Jones. “The birth control pill should not cause weight gain in the short or long term.” So there you have it.

Why might you gain weight while being on birth control?

While medical research has found no clear link between birth control and weight gain (including the pill, patch, ring, and nonhormonal birth control such as the copper IUD), there could be another explanation for the myth. Dr. Boyle explains that your body may coincidentally change while you’re using birth control, and sometimes the two are wrongly linked. 

There are some common reasons why you might notice your weight change that have nothing to do with the contraception you’re taking. They include: 

Natural weight gain as you get older

Throughout your cycle (and your life), hormone levels change. This starts in your teens, when you hit puberty, and doesn’t stop until you transition into menopause. Every month, you might experience premenstrual syndrome (PMS), which gives you a small reminder that your hormones are hard at work. This is all part of your body maturing and aging. And it’s known to influence the shape of your body. 

“People tend to gain weight over time,” says Dr. Boyle, “Weight gain, especially during adolescence, is normal and expected,” she adds. Studies have found that as we get older and enter new phases of our lives, we naturally gain weight, and the way that our body carries weight might slightly differ. As we age and move through adulthood, changes in our body’s fat tissue make it easier to gain weight, even if our diets and exercise habits don’t change. 

Water retention

If you’ve noticed a change in the way you look immediately after starting a new form of birth control, then you might want to look at your contraception — just not for the reason you first thought. 

Water retention describes what happens when your body swells due to fluid buildup in your tissue. It usually affects the ankles, legs, and face. This isn’t your body storing fat — it’s water. Some birth control options that include the hormones estrogen and synthetic progestin have been linked to water retention (as a minor, temporary side effect).  

“In the past, we used to tell women that hormonal contraception might cause a small amount of water retention but that it wouldn’t cause ‘real weight gain,’” explains Dr. Boyle.

Understandably, this may be a side effect you’re concerned about. However, it will typically go away by itself after your body adjusts to the hormones. It might end up feeling a little bit like bloating before your period. If you’re uncomfortable or in pain, however, you should reach out to your doctor.

Lifestyle changes 

During the time that you’re on birth control, you’ll likely have your fair share of stressful jobs, house moves, a partner or two, and may even become a parent. These are the things that keep life interesting. However, lifestyle changes can impact your weight. 

Other factors to be mindful of are: 

• Changes to your routine. For example, you’ve gone from having an active job to one where you sit down a lot, or you used to go to the gym but don’t have much time to do so anymore.
• Heightened stress levels
• Insomnia and difficulty sleeping

How to manage weight gain after stopping birth control 

If you’ve stopped taking birth control or have just switched over to a new form of contraception and have noticed a slight change in your body, then rest assured it’s entirely typical. 

As we mentioned above, your weight naturally fluctuates as you age, so it’s completely natural to see the numbers on the scale go up or down, regardless of which birth control method you’re on. 

More importantly, you shouldn’t feel bad about gaining weight. “Weight is not a direct marker for health,” says Dr. Boyle. “Regular physical exercise is crucial for our bodies and minds to be at their best.” 

If you’ve noticed a change in your weight and want to make some lifestyle choices to ensure you’re giving your mind and body everything it needs to thrive, why not consider: 

• Drinking lots of water and staying hydrated
• Eating a balanced diet with lots of protein and vegetables 
• Finding a way to exercise that you enjoy 
• And working out other coping mechanisms to deal with stress — this could be journaling, meditation, or talk therapy

Feeling anxious about your body can be horrible, but know you’re not alone. Try to reach out to someone you trust or your doctor to share any concerns you have. A problem shared is a problem halved, as they say. 

Weight gain and birth control: The takeaway

As we move through life, get new jobs, move to new cities, and potentially start a family, our bodies naturally change shape and size. There are so many different lifestyle factors unrelated to birth control that can cause weight fluctuations — from our diets to our exercise habits and overall health. 

Research hasn’t found a clear link between birth control use and weight gain, and it’s important to remember that contraception can impact people differently. So try to choose a contraceptive method that works best overall for you, and try to avoid ruling certain ones out based on assumptions. You can learn more about different birth control methods on an app like Flo. 

“Most contraception is not associated with weight gain,” says Dr. Jones. “Having said that, everyone’s body is different. Just make sure you speak with a health care provider to go over the pros and cons of each contraceptive method, so you can decide which is going to be the best one for you.”