Does the birth control shot cause weight gain

Hormonal birth control, like the pill, offers women a safe, effective way to prevent pregnancy.1 But like any medication, hormonal contraception can have side effects—including weight gain.

Women take the pill on a daily basis. To prevent pregnancy, the pill releases female sex hormones into the body to stop ovulation (when your ovaries release an egg).2

While some people experience weight gain on the pill, the effects are typically temporary, minimal, and manageable.3

Though some experts believe that weight gain is a side effect of the pill, it isn't known whether the pill directly causes weight gain.3,4

There are two main types of birth control pills. The combined pill contains both estrogen and progestin (a synthetic type of progesterone). The other type is known as the "mini-pill," which contains only progestin.2

Some studies suggest there may be an association between birth control pills and weight gain in some users. For example, a 2020 study found that the combined pill was associated with an increase in body fat and a reduction in lean body mass (muscles and other non-fat tissue) among people who were trying to lose weight.5 However, other studies haven't found any significant relationship between hormonal birth control and weight gain, in both women with or without obesity.6

Even with mixed research results, any weight gain while on the pill is usually a low amount. This is typically about 4–5 pounds on progestin-only pills, but again, it's unclear whether the pills or other factors caused the weight gain.3 Also, weight changes can vary across different brands of pills, which have different hormone doses.

For combined pills, some studies report over 4 pounds of weight gain in some users, while others report weight loss or no weight change at all.4

Experts believe several factors may contribute to weight gain on the pill:

• Age: Many people start taking hormonal birth control during adolescence or young adulthood. This is when some amount of weight gain is typical as you get older and your body develops.3
• Stress: Excess stress can increase your chance of weight gain.7 For people starting the pill as a teen or young adult, high school, college, or new relationships could lead to stress-related weight gain.
• Hormonal effects on appetite: Taking progestin might affect your appetite. Increased progesterone levels can trigger episodes of emotional overeating, and you might be more likely to eat foods packed with carbohydrates, salt, and fat.5
• More water in the body: Some birth control users also notice a side effect of fluid retention during the first few months of taking the pill, which can add a few pounds.8

Though there may be hormonal-related side effects associated with weight, oral contraceptives have changed over the years. When the pill was first introduced in the 1950s, it contained much higher doses of estrogen and progestin (over three times more than modern day pills). Today, the pill contains just a fraction of its original hormone doses, making it less likely to cause serious side effects.9

While the pill hasn't been linked to significant, long-term weight gain, other types of birth control may make more of a difference.

Birth Control Shot

The birth control shot contains medroxyprogesterone acetate, a type of progestin that helps prevent pregnancy. A healthcare provider would need to deliver this injection in your arm or butt every three months.10

Weight gain is a known side effect of the birth control shot.10 Research suggests that Depo-Provera (or DMPA), a common injection brand, can lead to average weight gains of nearly 3 pounds in a year and about 14 pounds within 10 years. DMPA injections have also been correlated with increased body fat.11

Birth Control Implants and Intrauterine Devices (IUDs)

Birth control implants and intrauterine devices (IUDs) are long-acting reversible contraceptives (LARCs). This means they can prevent pregnancy for several years and stop working after removal. IUDs are small devices inserted in the uterus, whereas the implant is a device that goes in the arm.12

These methods have been associated with moderate weight gain with long-term use:3,11

• Hormonal IUDs. These release progestin and are associated with average weight gains of about 1.5 pounds in a year and about 9 pounds in 10 years.
• Non-hormonal IUDs. Known as copper IUDs, these contain copper to help prevent pregnancy and are associated with average weight gains of about 0.5 pounds in a year and about 11 pounds after 10 years.
• Birth control implants. This device releases progestin. Several studies suggest the implant can lead to greater weight gain compared to non-hormonal birth control methods.

Researchers aren't entirely sure what causes weight gain on the pill. Genetics, lifestyle factors, and metabolism may all play a role.13 Other factors that may contribute to your chance of gaining weight while taking hormonal birth control can include:

• Mental illnesses: Mental health disorders are often associated with weight gain. Birth control users who have a comorbid mental health condition, such as depression or anxiety, may be more likely to gain weight on the pill.14
• Obesity or being overweight: A 2020 study compared two groups of women participating in an 18-month weight loss program. All were overweight or obese and actively trying to lose weight. One group took combined hormonal contraceptives (CHCs) throughout the program, while the other did not. While both groups lost weight during the first six months, women who were taking CHCs, including the pill, were more likely to regain weight in later months.5
• Other health conditions: People with hormonal imbalances or disorders, such as polycystic ovarian syndrome (PCOS), may have higher cholesterol and fat levels. Women with PCOS who take combined pills may have a greater increase in fat levels, compared to women without PCOS on the pill.11

You might notice some weight gain while you're taking hormonal birth control, but contraceptives aren't the only possible cause. Here are some healthy lifestyle changes you can make if you'd like to manage your weight while taking the pill:

• Reduce stress: Manage your stress and prioritize self-care by getting enough sleep, taking deep breaths or meditating, and taking time to relax.15
• Eat healthy foods: While you might feel hungrier than usual on the pill (especially at first), try to stick to healthy food choices, such as fruits, vegetables, and low-fat and fat-free dairy. Limit eating comfort foods that are high in calories, added sugars, or rich in carbohydrates and fat.5,16
• Exercise regularly: Physical activity, such as walking, swimming, or yoga, can help you manage your weight. The CDC recommends about 150 minutes of moderate aerobic activity each week.17

If you want to use contraception but don't want to gain weight, talk to your healthcare provider about your options. They can assess your overall health, give you helpful tips about healthy eating habits, and recommend birth control that doesn't lead to weight gain.

Some birth control methods less commonly associated with weight gain include:

• Birth control patch: This sticks to the skin and releases estrogen and progestin to prevent ovulation. The patch has side effects like skin irritation, headaches, and breakthrough bleeding, but it is less commonly associated with weight gain.4,18 Like the pill, any weight change while on the patch is minimal and may be due to outside factors.4
• Vaginal ring: This is a small, flexible plastic ring that works similarly to a skin patch. It's placed inside the vagina for 21 days at a time to prevent ovulation each cycle. Common side effects from the ring can include vaginal discharge, vaginal irritation, and nausea.18
• Barrier methods: Barrier methods of birth control, such as spermicide, condoms, diaphragms, cervical caps, and sponges, prevent your partner's sperm from reaching the egg. These methods are non-hormonal, so they won't affect your body's natural hormone levels or metabolism.19

In most cases, weight gain on the pill or another contraceptive isn't permanent. Still, if you're concerned about gaining weight, there are healthy ways to manage any changes in your body. Talk to your healthcare provider about which type of birth control will work best for you, your body, and your overall well-being.

Sources

1. Centers for Disease Control and Prevention. Contraception.
2. MedlinePlus. Birth control pills.
3. Lopez LM, Edelman A, Chen M, Otterness C, Trussell J, Helmerhorst FM. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2013;7(7):CD008815. doi:10.1002/14651858.CD008815.pub3
4. Gallo MF, Lopez LM, Grimes DA, Carayon F, Schulz KF, Helmerhorst FM. Combination contraceptives: effects on weight. doi: 10.1002/14651858.CD003987.pub5
5. Caldwell AE, Zaman A, Ostendorf DM, et al. Impact of combined hormonal contraceptive use on weight loss: a secondary analysis of a behavioral weight-loss trial. Obesity (Silver Spring). 2020;28(6):1040-1049. doi:10.1002/oby.22787
6. Mayeda ER, Torgal AH, Westhoff CL. Weight and body composition changes during oral contraceptive use in obese and normal weight women. J Womens Health (Larchmt). 2014;23(1):38-43. doi:10.1089/jwh.2012.4241
7. Geiker NRW, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa? Obes Rev. 2018;19(1):81-97. doi:10.1111/obr.12603
8. Graugaard-Jensen C, Hvistendahl GM, Frøkiær J, Bie P, Djurhuus JC. Oral contraceptives and renal water handling: a diurnal study in young women. Physiol Rep. 2017;5(23):e13547. doi:10.14814/phy2.13547
9. Liao PV, Dollin J. Half a century of the oral contraceptive pill: historical review and view to the future. Can Fam Physician. 2012;58(12):e757-e760.
10. MedlinePlus. Medroxyprogesterone injection.
11. de Melo AS, Dos Reis RM, Ferriani RA, Vieira CS. Hormonal contraception in women with polycystic ovary syndrome: choices, challenges, and noncontraceptive benefits. Open Access J Contracept. 2017;8:13-23. doi:10.2147/OAJC.S85543
12. The American College of Obstetricians and Gynecologists. Long-acting reversible contraception (LARC): intrauterine device and implant.
13. Lamiquiz-Moneo I, Mateo-Gallego R, Bea AM, et al. Genetic predictors of weight loss in overweight and obese subjects. Sci Rep. 2019;9(1):10770. doi:10.1038/s41598-019-47283-5
14. Sahle BW, Breslin M, Sanderson K, et al. Association between depression, anxiety and weight change in young adults. BMC Psychiatry. 2019;19(1):398. doi:10.1186/s12888-019-2385-z
15. Centers for Disease Control and Prevention. Coping with stress.
16. Centers for Disease Control and Prevention. Healthy eating for a healthy weight.
17. Centers for Disease Control and Prevention. Physical activity for a healthy weight.
18. The American College of Obstetricians and Gynecologists. Combined hormonal birth control: pill, patch, and ring.
19. The American College of Obstetricians and Gynecologists. Barrier methods of birth control: spermicide, condom, sponge, diaphragm, and cervical cap.

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