The Myth of Birth Control Pills and Weight Gain

The Myth of Birth Control and Weight Gain

It's a common concern: will using birth control lead to weight gain? As with many health myths, the answer isn't a simple 'yes' or 'no’ and has changed over time. Let's break down what the research says about birth control, especially hormonal contraceptives, and its potential effects on weight.

The Origin of the Myth

Historically, some birth control pills had high levels of hormones, which led to increased appetite and water retention in some users. As a result, early users might have experienced some weight gain. Over time, as the formulation of these pills improved and hormone levels decreased, the side effects were reduced. Per the NIH “Early iterations of the pill had drastically different dosages. The first marketed pill, Enovid 10, contained 9.85 mg of the progestin norethynodrel and 150 μg of the estrogen mestranol.7 Today’s pills contain dramatically lower hormone doses—0.1 to 3.0 mg of modern progestins and 20 to 50 μg of estrogens.”  The versions of the pill on the market in 2023 are markedly improved over the pills available on the market in the early 1970’s. 

Current Research

Current research on modern birth control pills largely debunks the myth of a direct correlation between birth control and weight gain. Here's what we know about the different kinds of the pills on the market today:

• Combined Oral Contraceptives (COCs): These pills contain both estrogen and progestin. Studies have found that most women do not gain or lose significant weight when taking COCs. Any weight changes are typically temporary and often due to water retention rather than actual fat gain.
• Progestin-Only Pills: These pills, commonly referred to as the "mini-pill," contain only progestin. While some studies suggest a possible slight weight gain with these pills, others have found no significant difference.
• Contraceptive Implants and Injections: There's more variance here. Some users report weight gain, while others don't. However, no conclusive evidence directly ties the contraceptive to substantial weight gain.
• Intrauterine Devices (IUDs): Both hormonal and non-hormonal IUDs have been studied, and there's no consistent evidence suggesting that IUDs cause weight gain.

So why do women perceive the pill as influencing any weight gains? A compelling argument can be made that the pill came out in a period marked by a distinct lack of body positivity, and that the same social forces that seek to control the shape and size of women’s bodies are the same social forces that seek to control what women do with their carefully maintained girlish figures. Setting aside discussions of why women worry about weight gain while on the pill, there are some things that happen to women’s bodies that do cause weight gain, and these things are sometimes coincidentally happening while women are on the pill. 

Potential Reasons for Perceived Weight Gain

• Water Retention: Hormonal fluctuations can cause temporary water retention. This isn't true weight gain in terms of fat but can make the scale number increase for a brief period.
• Natural Weight Fluctuations: It's natural for our weight to fluctuate for various reasons, such as dietary changes, stress, and other hormonal changes (e.g., menstrual cycle).
• Other Factors: Age, metabolism, and lifestyle changes can also contribute to weight gain or loss over time. Starting birth control might coincide with these factors, leading to a misconception about causation.

Assessment: Weight gain can happen, but isn’t because women are on the pill

The myth of birth control leading to significant weight gain is rooted in outdated information and misconceptions. It's essential to differentiate between temporary weight fluctuations and actual, sustained weight gain. While individual reactions to birth control can vary, it's crucial to approach the subject with the most current and comprehensive research in mind. If you have concerns about birth control and its potential effects on your body, consult with a healthcare professional to make an informed decision. And if you need someone to tell you you’re beautiful the way you are, whether or not your weight has gone up or down, consider this a beautiful dose of support!