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“The Pill Made Me Gain Weight!”

There are many different types of birth control, some hormonal and some not, so not all will affect the body in the same way. The oral contraceptive pill (OCP) more commonly known as the pill is one form of hormonal contraception that contains synthetic hormones including ethinyl estradiol and progestins which mimic the female hormones oestrogen and progesterone.

The pill is commonly used among women for a variety of reasons. Like most medications, the pill can have some unpleasant side effects such as breast tenderness, mood changes such as anxiety, headaches, nausea and weight gain. Weight gain is actually one of the primary reasons women discontinue birth control.

So is There Any Truth to This?

We all know that energy balance is key to weight gain, maintenance or loss. It’s important to firstly note that the pill does not directly or magically make you gain weight. However, it does affect important factors which contribute and influence weight gain. So while the pill may not directly cause you to gain weight, it can affect appetite, cravings for sweet foods, water retention and your ability to build muscle, which can all contribute to changes in your body composition such as weight gain.

Increased Appetite

The most notable effect mentioned by users is an increase in appetite. It is thought that this is due to the progesterone content of the pills. With an increased appetite usually comes to increased caloric intake which could either make fat loss efforts harder or lead to weight gain.

Water Retention

Some pills can also cause increased water retention in the body. It’s important to bear in mind that this isn’t fat gain but can make users weigh in heavier and feel more bloated.

Decreased Ability To Gain Muscle Mass

The pill may also affect your body composition by making it slightly harder to gain muscle mass. This effect has mainly been seen in pills containing antiandrogens, also known as androgen antagonists or testosterone blockers. This isn’t surprising as testosterone plays a key role in building lean muscle.

A study by Ruzic et al (2003) concluded that pills that contained antiandrogens had a negative effect on muscle strength, minimizing the effects of strength training in women. This effect could be due to pills with antiandrogenic effects leading to anti-anabolic effects on muscle.

Does the Pill Affect My Metabolism?

The impact of the oral contraceptive pill on metabolism has also been an area of great interest. Studies by Diffey et al (1997) among others have not found the pill to have any negative effects on basal metabolic rate (BMR) in users and sometimes, can contribute to increased BMR.

Do These Changes in Appetite Happen to Everyone?

No! Research has shown that responses to the pill are highly individual and vary depending on the pill used. While some people gain weight, there are also those who lose weight and some who maintain their weight.

Do Other Forms of Contraception Cause Weight Gain?

It’s also worth noting that other forms of birth control have been shown to contribute to weight gain. The most notable is the depo-provera injection. A 2009 study found that women who received this shot had increased cravings for highly palatable foods which are usually high in fat, sugar and higher in calories too, as well as a profound impact on appetite. Weight gain in users is highly variable and ranged from 3.0 kg after 12 months’ use, to 9.4 kg after 18 months’ use. The study also found that the weight gain in the first six months predicted the subsequent weight gain (ie. Women who gained the most weight would continue to gain the greatest amount of weight as time went on).

What Can I do if I Think The Pill is Making Me Gain Weight?

If you think the pill is causing you side effects such as increased appetite and subsequent weight gain, it’s important to speak to your GP. There are also some tips you can bear in mind if you feel like your appetite has increased or you’re retaining water:

  • Keep protein intake high! Protein is the most filling of all the nutrients. It’s also the most thermogenic macronutrient meaning your body uses more calories to digest protein than it does carbohydrates or fats. A good rule of thumb is to include a high quality protein source at each meal such as chicken, beef, fish, eggs, Greek yoghurt or protein powder

  • Practice mindful eating. This means taking time to really enjoy your meal rather than eating quickly. Take some deep belly breathes before eating to get your body into rest and digest mode. Time yourself and try to make your meal last 15 minutes. Chew your food really well!

  • Increase water intake

  • Limit high sodium foods if you feel like you’re retaining water as these can worsen water retention

  • Increase intake of fruits and vegetables high in potassium such as spinach, broccoli, bananas, avocado and sweet potato


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