What are patients seeing on social media about weight gain and birth control?
Patients often see online that all birth control methods inevitably cause weight gain, with anecdotal stories going viral as proof.
What’s the evidence about birth control and weight gain?
Weight gain is one of the most common reasons people cite for avoiding, stopping, or switching birth control. Social media has only amplified these fears.
Here’s what the evidence actually shows:
- A 2014 Cochrane Review concluded that while there is not enough high-quality data to fully determine the effect of hormonal contraception on weight, there is no strong evidence linking hormonal contraception to significant weight gain.
- A 2016 Cochrane review of progestin-only methods had similar findings.
- Across studies, average weight change for hormonal contraception users is typically 2–4 pounds, much of which may be due to water retention from estrogen.
- Perception matters: many people feel like they’ve gained weight—even when objective measurements don’t show much change.
The one exception? Depot medroxyprogesterone acetate (DMPA)
- DMPA is the only method with clearly documented weight effects, though it does not appear to affect all users the same. About 1 in 4 patients may gain weight with DMPA.
- People who gain more than 5% of baseline weight within 6 months of starting DMPA are more likely to continue gaining.
Citations
- Gallo MF, Lopez LM, Grimes DA, Carayon F, Schulz KF, Helmerhorst FM. Combination contraceptives: effects on weight. Cochrane Database Syst Rev. 2014;2014(1):CD003987. Published 2014 Jan 29. doi:10.1002/14651858.CD003987.pub5
- Le YL, Rahman M, Berenson AB. Early weight gain predicting later weight gain among depot medroxyprogesterone acetate users. Obstet Gynecol. 2009;114(2 Pt 1):279-284. doi:10.1097/AOG.0b013e3181af68b2
- Lopez LM, Ramesh S, Chen M, et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2016;2016(8):CD008815. Published 2016 Aug 28. doi:10.1002/14651858.CD008815.pub4
Talking with patients about weight gain and birth control
Get curious:
Ask an open-ended question to understand their concerns and personal context.
Can you tell me more about what you’ve heard or seen about weight gain while using birth control?
Have you had any past experiences with weight changes and birth control?
Acknowledge concerns & normalize:
A lot of my patients have similar concerns about that.
It can be worrying to hear those kinds of stories on social media.
Clarify with evidence and empathy:
Tailor your response to individual concerns.
If they’re expressing a fear of weight gain:
We know that most people don’t gain much weight with birth control and the type of method makes a difference. We can definitely talk through the options and pick one that doesn’t typically cause any weight change if that’s something that’s important to you in your method.
If they are reporting personal weight gain on a current method:
Everyone’s body responds differently. Some people do notice weight changes. We can discuss other options if you’d like. And we can also consider other things that might be contributing to the change in weight.
If they are interested in DMPA:
Some people on Depo don’t gain weight at all—but others do. If you’d like to give it a try, we can keep an eye on things before your next injection and go from there. How does that sound?
Diving deeper
Focus on multiple markers of health and share those with patients. Blood pressure, blood sugar levels, regular exercise and balanced nutrition can provide a more comprehensive view of health and can help patients focus on data points other than just the number on a scale.
Gently introduce the idea that multiple factors affect weight.
Sometimes weight gain can be due to other factors. If our thyroid, a gland in our neck, is out of balance that can cause weight changes. We can check your thyroid level today if you’d like.
Things like stress, sleep, eating patterns, and activity level can all influence weight too. If you’re interested, we can also talk about ways to support your overall well-being.
Key takeaways
- The evidence shows that most hormonal contraceptives do not cause significant weight gain for most users.
- DMPA may be more likely to lead to weight gain in some people.
- Frame weight changes in a holistic context, emphasizing that many factors—not just birth control—affect body weight.
- Support reproductive autonomy by ensuring patients have accurate information and feel empowered to choose the best method for them.