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How to prevent gaining weight on birth control

Busola, 32years, had always been thin and active. But things changed after giving birth to her first child and going on birth control. Six months after going on birth control, she no longer fit into her favorite jeans. Was birth control behind her weight gain—or something else?

She sent me a message via facebook messenger asking me if I’ve ever worked with women trying to lose weight while on family planning.

I said Sure.

Then she proceeded to tell me about how she has always had a fast metabolism. Thanks to genetics and being very active, She never had to think about weight or diet prior to getting married. But once she had her baby and decided to get on birth control, her body started to change.

After six months on the birth control, she noticed that my favorite jeans weren’t fitting the way they used to. She was also hungry all the time, even after a big meal.

It wasn’t until she took her baby for her 9 months vaccination and she decided to hop on the scale to even know how many kgs she has gained that she realized that she had gained a whopping 12kg.

She started working out and “tried” to cut out carbonated drinks and fast food, but she was still gaining weight in her face, stomach, and thighs.

After trying exercise and diet with just a little change and she still couldn’t figure out why she was gaining weight when the only thing that had really changed about her routine was going on birth control, she decided to reach out to me since I’m a Medical Doctor and a Nutritionist.



Guess what I told Busola,

I told her that while it is possible for her to gain weight on birth control, there could be other culprits responsible for her recent weight gain.

Let’s take a look at this very important subject matter step by step.

There are 2 major classes of Birth Control Methods.

  • Hormonal Methods

  • Non-Hormonal Methods

Weight gain is a common concern for many people who are looking to start hormonal forms of birth control. Tales from others who’ve gained weight on hormonal birth control may be enough to even deter some people from trying it. But it shouldn’t be.

Common types of hormonal birth control methods and their effects on weight gain.

1. Combined Hormonal Methods

Combined hormonal methods contain a synthetic estrogen (ethinyl estradiol) and one of the many progestins approved by different countries.

The combined estrogen/progestin drugs can be delivered by pills, a patch, or a vaginal ring.

  • Combined oral contraceptives (COCs, “the pill”).

COCs contain a synthetic estrogen and a progestin,

A woman takes one pill daily, preferably at the same time each day.

  • Contraceptive patch.

This is a thin, plastic patch that sticks to the skin and releases hormones through the skin into the bloodstream.

The patch is placed on the lower abdomen, buttocks, outer arm, or upper body.

A new patch is applied once a week for 3 weeks, and no patch is used on the fourth week to enable menstruation.

  • Vaginal ring.

The ring is thin, flexible, and approximately 2 inches in diameter.

It delivers a combination of ethinyl estradiol and a progestin.

The ring is inserted into the vagina, where it continually releases hormones for 3 weeks.

The woman removes it for the fourth week and reinserts a new ring 7 days later.

A little medical jargon

All of the products work by inhibiting ovulation and thickening cervical mucus.

This simply means that combined hormonal methods are effective because they fool the body into believing it’s already pregnant. They supply the body with estrogen so that it has an excess circulating supply of it. Exactly the same way it would be if you were pregnant.

This causes water retention because estrogen stimulates the production of a certain compound called renin-angiotensin from the kidneys. This compound promotes fluid retention. The amount of fluids that are retained is in direct relation to the amount of estrogen found in the pill.

The general rule is that oral contraceptives with 20mcg of estrogen or less are recommended for women who want to avoid weight gain while on the pill. As well, pills that contain drospirenone as the progestin component (Yaz, for example) don’t promote weight gain the same way because drospirenone acts as a diuretic.

A diuretic helps to reduce water retention so this will counter the effect of the estrogen.

Because we all react to drugs differently, individual genetic makeup can play a role in the severity of this too. Certain women will be much more naturally prone to water retention.

An unhealthy lifestyle that comprises of eating processed foods and oversalted foods can also contribute to water retention.

However, the good news is that weight gain from water retention due to estrogen usually subsides after you have your period.

Increase in appetite

Another way you may gain weight from birth control is you’re unable to resist the way some of them make you want to eat more than you usually would.

Yes, some combined hormonal methods can be appetite stimulators. An increased appetite can still include mostly smart diet choices, but when they don’t this results in weight gain.

Combined hormonal methods especially oral contraceptives often raise insulin levels. When insulin levels in the body rise, the rate at which calories from food is utilized and stored becomes more than usual. And, as the good Lord would have it, many of the foods that you will crave when your appetite is stimulated will be loaded with refined carbs.

How to prevent gaining weight on birth control

2. Progesterone-only contraceptives

This can be further classified into short acting and long acting.

Short-acting includes Injectable birth-control aka “The shot” and progesterone only pills.

Long-acting reversible includes Implants and Intrauterine devices.

  • Injectable birth control aka “The Shot”.

This method involves the injection of a progestin, Depo-Provera (depot medroxyprogesterone acetate [DMPA]), given in the arm or buttocks once every 3 months. Occasionally, Noristerat may be given, and that lasts for 8 weeks.

Weight gain on Depo shot

Some studies have shown that people using the shot gain weight and others show no change in weight attributed to the shot.

For example, this study shows that during the first year, women gain about 2 kg(4.4 lbs) and weight increases as time passes.

Even studies that measured changes in weight for people using the shot for longer periods of time give conflicting results.

In one study, shot users increased their weight by 5.1 kg(11.2 lbs) over 3 years but in another study, shot users gained 8.0 kg (17.6lbs) over the 3-year period.

  • Progestin-only pills (POPs).

A woman takes one pill daily, preferably at the same time each day.

This literature review showed that study participants gained, on average, fewer than 4.4 pounds after 6 or 12 months of using a progestin-only pill.

  • Implants

Implants are implantable rods. Each rod is matchstick-sized, flexible, and plastic.

The rod releases a progestin and can remain implanted for up to 3-5 years.

Commonly used Implants are -Implanon and Nexplanon, which release etonogestrel; and a two-rod method, Jadelle which releases levonorgestrel.

Implants and weight gain

Like other forms of hormonal birth control, the implant may cause some side effects, including weight gain.

However, research is mixed on whether the implant actually causes weight gain.

This study found no evidence of weight gain from short-term implant use while another school of thought on implant attribute weight gain to hormone imbalance and living an unhealthy lifestyle.

  • Intrauterine Device

An intrauterine device (IUD), also known as an intrauterine system (IUS), is a small, T-shaped device that is inserted into the uterus to prevent pregnancy.

A hormonal IUD or IUS releases a progestin hormone (levonorgestrel) into the uterus. The released hormone causes thickening of the cervical mucus, inhibits sperm from reaching or fertilizing the egg, thins the uterine lining, and may prevent the ovaries from releasing eggs.

IUD weight gain

Some women have reported weight gain on IUD but similar to other hormonal contraceptives highlighted above, research is inconclusive. Some studies showed no correlation between the use of IUD and weight gain while others recorded a minimal change in weight.

For example, this study showed weight increases of 3.1 kg (6.8 lbs) at the end of the fifth year among users of the Levonorgestrel IUS.

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Hormonal methods are preferred because of easy compliance and effectiveness.

It is important to note that there are other side effects hormonal birth control but this article is about gaining weight on birth control so that will not be addressed here.

Your choice of birth control should be made after careful consideration of your age, current weight, family history of Hypertension, Diabetes, Stroke, Breast Cancer, how soon you want to have your next baby, etc.

That being said, most studies oppose the theory of gaining weight on birth control.

For the studies that support the possibility of gaining weight on birth control, the average weight gain is similar to weight gain expected in a woman of reproductive age over the years.

From all the research highlighted above, Depo-Provera has the highest amount of weight gain – 8kg(17.6lbs) over a 3 year period.

Therefore, if you gain substantially more than that after starting hormonal birth control, your weight gain is likely caused by something else.

If you notice a weight gain of over 10kg within 3 years of starting a birth control method, it’s best to first explore other common causes of weight gain.

Other common causes of weight gain

Changes in routine

If you’ve recently changed jobs and find yourself sedentary for most of your day, you may begin noticing a gradual weight gain. Sitting for large segments of your day can lead to weight gain, among other side effects.

New environment

A change in environment is a common culprit when it comes to weight gain at least for me. Most of the times, we have no control over what we eat when we are at a new place. It usually takes a while before we are able to adjust our routine.

Changes in diet

Are you eating out more than usual? Gradual increases in your calorie intake can lead to weight gain.

Monitor your daily calorie consumption with the help of a food tracking app. Doing so can help you maintain your current weight or lose some weight if that’s your goal.

New relationship

A new relationship equals more hanging out and eating unhealthy foods. The other type of relationship that can be a culprit is the relationship with your baby. For Busola, we were able to trace her weight gain to when she stopped exclusive breastfeeding at 6 months. She introduced normal adult meals to her baby so she has to cook more. Another issue is that her baby wasn’t eating most of the foods, so she was the one eating the foods in addition to her normal meals.

One golden rule for Mums – Please don’t eat your children’s leftovers. If you must because you are trying to avoid wastage, then it should be a meal for you.

Reduced metabolism

Depending on your age, your metabolism could be contributing to changes in your weight and energy levels. As you age, your metabolism can take a nosedive. Without your body’s natural calorie-burning ability, you may notice weight gain.

Changes at the gym

Are you doing more weightlifting or muscle-building exercises? Increased muscle mass might explain the increase you see on the scale.

You’ll probably still feel the same size. Your jeans will fit the same as before or better, but the number you see on the scale may go up. This is because you’re building muscle.

Stress, depression, and other medical conditions —could also be responsible for eating more than usual or choosing foods that aren’t healthy without realizing it.


How to prevent gaining weight on birth control

How to prevent/manage weight gain on birth control

Keep these tips in mind if you’ve noticed a change in your weight since you started birth control:

1. Give it time

It’s possible you’ll experience a slight increase in weight immediately after beginning birth control. This is often the result of water retention, not actual fat gain.

It’s almost always temporary. Given time, this water will go away and your weight should return to normal if you’re living a healthy lifestyle.

2. Drink plenty of water and other fluids.

Although birth control pills can cause water retention, you need to drink plenty of water and other healthy fluids such as green tea or moringa tea.

This will help in flushing out the excess water and prevent any more water from getting retained in your body.

Once you are able to establish the right balance of fluids in your body and maintain it, the excess water weight will be lost.

Most times I recommend 2-3 liters per day but be sure to adjust based on how your body responds.

3.Curb increased appetite by modifying your diet

One of the side effects of birth control is an increase in appetite. This is why it is important to monitor your intake of calories. Due to this increase in your appetite, you may be consuming more calories than you should without even realizing it. Keep track of the number of calories you consume and compare it to the amount that you burn. Make adjustments to your daily calorie intake or physical activities so that you get the right balance to help you with steady weight loss.

Eliminating processed foods from your daily diet will help with weight loss and improve your general overall health as well. If your appetite increases because of the birth control pills you are taking, the amount of food you require to satisfy you will also increase. 

Apart from a meal plan filled with high volume- low caloric foods, high fiber, moderate fat and moderate protein diet which I have tweaked over the years to help curb excessive cravings and appetite for my Clients struggling to lose weight on birth control.

4. Another pro tip is Apple Cider Vinegar.

Apple Cider Vinegar is amazing for so many things but in this case, we’re using it for its appetite suppressant and diuretic benefits.

If you want to incorporate apple cider vinegar into your diet, start with 1 teaspoon(5mls) in 500mls of water.

5. Move a little more

Increase your physical activity.

Adopting a more active lifestyle may help you drop the few pounds you might gain after starting birth control.

High-intensity interval training(HIIT) is a very good exercise that helps boost metabolism and increase caloric burn within a short period of time. This has really helped a lot of my clients lose weight on birth control. But, you can start with simple exercises that you can do in the comfort of your home.

6. If you’re on the pills, use it at the same time every day

Make it a point to take your birth control pills at the same time every day. This will help you gain hormonal stability. As shifts occur in your hormones, changes can be seen in your mood as well. This can result in changes in the levels of appetite and fatigue. Emotional eating or having less energy for workouts can also be caused by hormonal shifts.

7. Change your birth control method

Estrogen can stimulate your appetite and cause you to retain water. If your contraception has a high dose of estrogen, you may be more likely to see a change in your weight.

Make an appointment to speak with your doctor if you’re concerned your weight gain may be related to your birth control. All birth control pills are different, so it’s possible your doctor can find one that has a lower dose of estrogen and doesn’t affect your appetite or your weight.

Just remember that it might take time to find the right type of hormonal birth control that keeps your weight steady. “Sometimes you have to change them two or three times to find the brand that works best for you, and what works best for you may not work best for your closest BFF,”

Do you have any bad experience with birth control? Share with me in the comment section below!

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