The Pill and weight

Since the introduction of oral contraceptive pills in the 1960s, the issue of the Pill and weight change has been controversial.

Most doctors accept that the first generation of contraceptive pill may have caused weight gain in some users. This was because early contraceptive pills had very high hormone levels (oestrogen and progestogen), almost 1000 times more than contraceptive pills today. Too much oestrogen can cause fluid retention and increase your appetite, making you gain weight.

Today, contraceptive pills have much lower doses of hormones. The NHS argues that it is a common myth that the Pill causes weight gain in women. They have published several papers and studies to show that there is little medical evidence that the latest contraceptive pills cause women to gain weight.

However, it's important to remember that there is always the possibility of side effects when taking medication. Everyone will react differently to the Pill, and differently to the different types of contraceptive pill available. One of the side effects could be minor weight gain, usually caused by fluid retention, but this is only temporary. Most side effects of the Pill will pass in 2-3 months.

Do you gain weight when on the Pill?

The short answer to this question is that you shouldn’t, but that a small amount of short-term weight gain is possible.

One of the most recent studies into weight gain on the Pill was published in 2011. Researchers at Gothenburg University in Sweden carried out this study, testing some 1,400 fertile women taking the contraceptive pill for a period of either 15 or 25 years. Research showed no solid link between weight change and the contraceptive pill. The only factor linked to weight gain was age: women tended to gain around 0.45kg every year as they got older.

The results of this study have been generally accepted, although there are some limitations with it. Around 50% of the women dropped out halfway through testing, and factors such as diet and exercise were not properly analysed. Most doctors agree that the most important factor in weight gain is a poor, high-calorie diet and lack of exercise.

It is also important to remember that this study only looked at long-term weight change. Lots of women using the Pill are more concerned with weight gain in the short-term, which was not examined.

Does the Pill cause you to lose weight?

The Pill should not cause any long-term weight change, either weight gain or weight loss.

A second important 2011 study was conducted by researchers at Oregon Health and Science University in Portland, USA. The results from this study also support the idea that there is no link between weight change and the contraceptive pill.

The study was carried out on 10 obese and 10 normal weight macaque monkeys. The monkeys were given the oral contraceptive pill for 8 months. All the monkeys lost a small percentage of their body fat during these 8 months, and this was most marked in the 10 obese monkeys. The main limitation with this study was the lack of a test group of monkeys not taking the contraceptive pill. It is therefore difficult to know whether the changes in weight were due to the Pill itself.

Whilst the results of this test cannot be directly applied to humans, this study has been used to support the argument that the Pill alone does not cause weight gain.

Does weight change depend on the type of Pill you take?

The Pill is available in two forms in the UK: the combined oral contraceptive pill (COC), and the minipill or progestogen-only pill (POP).

Different women will react differently to the different pills, and it is important to spend some time before choosing your contraceptive pill to work out which one will be the best for you.

There is no evidence to show that either the combined or the minipill will cause significant weight change, although side effects tend to be loss common with the minipill because they include a lower dosage of hormones.

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