Just Facts: Will the Pill Make Me Fat?


RH Reality Check is partnering with Planned Parenthood of New York City to provide evidence-based information on the contraceptive pill.  See also the feature article this week by Kirsten Moore and Aimee Thorne-Thompsen examining the case for over-the-counter access to the contraceptive pill.

The Birth Control Pill: it’s one of the most widely used forms of contraception, so is there any wonder that it carries so many misconceptions?

We here at Planned Parenthood of New York City field all kinds of questions about birth control pills — will they make me fat, will they make me unable to have kids, do I need to take a break after eight straight years of hormones? So we decided it was time to break it down for you, and give you the straight facts about what is and isn’t true and just where all those rumors come from.

Keep in mind that we’re not giving anyone medical advice, and that making good decisions about sexual health and birth control is vastly different for each person. That means that no matter how much what we explain rings true, you should always discuss these topics with your health care provider to figure out what works best for your health, body, and lifestyle.

Before we get started, let’s go over some birth control basics: 

So what is the Pill anyway? The birth control pill is an oral hormonal contraceptive that’s taken daily. While there are many different brand name and generic versions of the Pill, they all basically work the same way. Made up of estrogen, progesterone, or a mix of both, these hormones suppress ovulation, ensuring that a woman’s ovaries don’t release eggs. And they thicken a woman’s cervical mucus, thereby blocking sperm from getting past the cervix.

Even though pills all work the same way, that doesn’t mean they’re all the same. They have different mixes and levels of hormones. Some may even include extras, like iron supplements. Because of this, they all affect us differently – meaning that the side effects you get with one pill may disappear once you change brands. Often finding the right birth control is a process – trying many different brands until you find one that mixes well with your body’s chemistry.

The Myth: The Pill Will Make Me Fat. Heard about the “Freshmen 15” — the extra pounds you gain in your first year of college? Well word on the street is that it’s nothing compared to the “Progesterone 15” – the weight you gain when you start on the birth control pill. We at Planned Parenthood of New York City often have patients come into our centers complaining about weight gain, bloating, or extra poundage once they start taking the Pill.

Let’s debunk this one right now. The birth control pill cannot make you gain weight. It will not make you fat, it will not add on pounds, it will not make you heavier.

So what gives?

Well, a few things may be going on. First of all, while the Pill won’t make you gain weight, what the Pill can make you do is retain water – creating the appearance of weight gain. This isn’t a permanent change, and will usually go away once your body has adjusted to the new hormones, after about a month or two.

Second of all, if your birth control pill contains progesterone (most do), that might be to blame. See, while progesterone doesn’t make you gain weight, it can, for some people, cause an increase in appetite. Increased appetites can lead to eating more, which, yes, will lead to weight gain.

Our medical staff has a favorite saying about this: “The Pill doesn’t make you gain weight, calories do.”

Keep in mind, however, that this increase in appetite is not exponential. Your appetite will increase slightly and then level out, meaning that once your body adjusts you shouldn’t continue to gain weight.

So what can you do if this is happening to you?

Always discuss any concerns you have about your birth control method with your health care provider. But, as mentioned above, most of these effects will disappear over time, as your body adjusts to the new hormone levels.  Wait a few months and see what happens. And if you’re still unhappy with the results, talk to your provider about finding a method that works better for you. 

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  • grayduck

    Please answer the following question. “Why use the birth control pill when it is 160 times as likely to fail as Implanon?”

     

    http://www.contraceptivetechnology.org/table.html

     

  • squirrely-girl

    … not every woman wants a long-term form of birth control.

    … some women aren’t good candidates for them.

    … because some women have negative side effects.

    … because not all insurance plans cover the costs of the implant or insertion.

    … because some people REALLY hate needles.

    … because some people dislike the idea of an implant under their skin.

    … because implants haven’t always had the greatest reputation.

    … because if it’s already difficult to come up with the money for the birth control pills, it’s going to be even harder to come up with the funds for the implant and insertion. 

    … because not every decision in life is based purely on numbers :/

     

    There are PLENTY of reasons why a woman would choose one form of birth control over another. Please free to elaborate everybody :)

     

    By the way, I personally use this form of birth control and I’m a pretty big ol’ fan but, like all forms of birth control, it’s really an individual decision. 

  • sweetchild92

    The pill is seen, at least among some, if not many, as the default hormonal contraception. Unfortunately, there probably are quite a few women who just simply don’t know about implanon. I see no ads for it.

    Just today I had a doctor’s appointment, and birth control came up (pain related), and not one mention was made of any other method aside from changing my pill. Ok, once. The doctor mentioned I’m too young for Ortho Evra (…at 19, despite that I had onc eused it when I was like 14…). And I have had the ability to learn about all these different methods, including the more reliable ones. If women aren’t given accurate information on all their options, they’re not being able to choose implanon :/

  • squirrely-girl

    … a provider’s own biases or lack of knowledge can greatly limit a woman’s options. 

     

    Additionally, the insertion of Implanon requires specialty training as it’s a weird, rather large, needle/syringe contraption and the location needs to be exact. I had mine done at my university’s student health services where they have a nurse practitioner who specializes in women’s reproductive health needs. Likewise, because of the shelf life and overall expense, Implanon had to be specially ordered and it took a couple of weeks for me to get an appointment. Quite simply, not every provider has been trained on these nor do some want to be trained. :/

  • sweetchild92

    “nor do some want to be trained. :/”

     

    That’s depressing. And just shows how further limited access to longer lasting/more reliable contraception is.

  • grayduck

    squirrely girl on August 5, 2010 – 12:05am: [Finally they have a blockquote option without disabling rich-text!- GrayDuck] “Because…not every woman wants a long-term form of birth control.

     

    What difference does it make whether some other woman prefers to use an ineffective method of contraception? Why should women have their decisions be dictated by the prior, largely uninformed, decisions of other women? As you yourself say: “…it’s really an individual decision.” And, what evidence exists showing that women, when told about the ineffectiveness of birth control pills and the relative effectiveness of Implanon, prefer to use birth control pills rather than Implanon (absent some overriding medical reason stopping them from using Implanon)?

     

    “…some women aren’t good candidates for them.”

     

    Why not?

     

    “… because some women have negative side effects.”

     

    What negative side affects afflict Implanon users that do not afflict birth control pill users? Both are hormonal.

     

    …because not all insurance plans cover the costs of the implant or insertion.

     

    Which insurance carriers refuse to cover implants but do cover birth control pills? What is your evidence?

     

    … because some people REALLY hate needles.

     

    Like who? Until recently I gave myself rather painful shots every week. This procedure is once every three years.

     

    http://www.youtube.com/watch?v=Ir2MHzq9RYA

     

    “… because some people dislike the idea of an implant under their skin.”

     

    Who? Who prefers a higher risk of pregancy to having an implant under their skin?

     

    “… because implants haven’t always had the greatest reputation.”

     

    Why is the largely unfairly-gained reputation of Norplant a reason to not use Implanon? Even to the extent that some of the complaints about Norplant were legitimate, those problems have mostly been overcome with Implanon’s design.

     

    “… because if it’s already difficult to come up with the money for the birth control pills, it’s going to be even harder to come up with the funds for the implant and insertion. “

     

    How so? The evidence that I have seen from the UK indicate that Implanon is a relatively inexpensive form of contraception, as long as the users do not discontinue prematurely.

     

    “I personally use this form of birth control”

     

    You use Implanon?

  • grayduck

    sweetchild92 on August 5, 2010 – 3:13am: “Unfortunately, there probably are quite a few women who just simply don’t know about implanon.”

     

    That is my point. Why is RH Reality Check posting articles about birth control pills when the public knows far more about them than about Implanon? I think Planned Parenthood is deliberately seeking to keep women uninformed about Implanon because they know that it has the potential to ruin the company’s abortion business.

  • grayduck

    “And just shows how further limited access to longer lasting/more reliable contraception is.”

     

    There are many providers that offer it.

     

    http://www.implanon-usa.com/consumer/howdoistart/findanhcp/index.asp?C=82628403961646759259&svarqvp2=0

  • arekushieru

    Really?  They make more money off of the ‘pregnancy industry’ than they do the ‘abortion business’, so why would they be worried about something they make less money at than what they make more at?  Hmmm…?

  • arekushieru

    And that doesn’t disprove anything sc said.  She never said there weren’t many providers.  Because there IS a difference between that and ‘enough’, after all….

  • squirrely-girl

    And, what evidence exists showing that women, when told about the ineffectiveness of birth control pills and the relative effectiveness of Implanon, prefer to use birth control pills rather than Implanon

    Women who want to get pregnant within the next three years. Implanon is a three year implant. Yes, you could have it removed early, but this would make it quite a waste of money. Some women use birth control to space children, not avoid them altogether. When I was still in the Army, plenty of soldiers’ wives would try to not get pregnant while they were home on leave, which was usually a two to four week window, depending on where they were deployed or stationed. Otherwise, they just weren’t on anything.

    Why not?

    What negative side affects afflict Implanon users that do not afflict birth control pill users? Both are hormonal.

    Yes, both are “hormonal” but there are over 70 different types of the traditional birth control pill and each of them has varying amounts of those hormones because some women react very negatively to one dosage but not another. If every woman reacted to every pill the same, we wouldn’t need so many. Implanon only comes in one dosage. Whereas most pills are contain two hormones, Implanon (like Depo-Provera and the mini-pill) contains only one of those hormones, progestin. Progestin-only hormonal contraceptives are associated with increased rates of ectopic pregnancy, bleeding irregularities, and ovarian cysts. Quite simply, these aren’t risks that some women are willing to take, particularly if they’ve already suffered through them. Likewise, women who have had bad hormonal experiences with Depo (off the top of my head, I know at least four women who bled for three months straight after getting the injection) or the mini-pill are generally not ideal candidates for another progestin-only hormonal contraceptive.

     

    Additionally, some women take certain forms of the pill to help treat their acne as well as provide contraception. Some women report a worsening of their acne as well as greater weight gain with progestin-only forms compared to the two hormone versions of the pill. Additionally, while all hormonal birth control has an increased risk of blood clotting, the big difference between the pill and Implanon is you can just stop taking the pill. A woman who is planning to undergo surgery or multiple surgeries would probably not want this type of birth control as surgery and/or best rest increase the likelihood of blood clots. Similarly, if you don’t react well to one type of the pill, you’re only out the cost of that pack and you can switch right away… you don’t need to schedule an appointment and waste all of that money (it’s well over a grand without insurance btw and that cost doesn’t include insertion).

    And, finally, the implant goes in the upper part of your non-dominant arm. Kinda random, but I have quite a few tattoos and given it’s location, this implant isn’t something I should be going over with a tattoo gun :)  I’m in the middle of working on a sleeve on my dominant arm so it wasn’t a huge deal to put off work, but it is something I gave some thought to. Just saying. Similarly, and I’m totally just shooting from the hip here, I can imagine that women with certain skin or tissue conditions probably wouldn’t be great candidates either. 

    Which insurance carriers refuse to cover implants but do cover birth control pills? What is your evidence?

    Honestly it just depends on the insurance carrier and plenty of dick companies will do anything they can to deny coverage for anything. Outside of my anecdotal experiences with insurance companies, it can REALLY make a difference whether the plan considers it a medical device or a “physician-administered drug.” There’s a big difference between the two for many insurance plans. Implanon considers it the latter, but given that it is a medical plastic (very similar to the NuvaRing material), some insurance companies disagree. It took me several calls and faxes from my provider to get it approved. Feel free to check out the Implanon website for more info on that.

    Like who? Until recently I gave myself rather painful shots every week. This procedure is once every three years.

    Like people with histories of childhood diseases who had to get lots of injections, IVs and blood draws, for one. I have a friend who survived a childhood cancer and now vomits/dry heaves every time she’s around needles :( Honestly, having worked with enough people with phobias, there are plenty of irrational fears out there, needles are actually a pretty common one. And with regard to you giving yourself painful shots every week, 1) there does seem to be a difference when people do things to themselves, and 2) you should try to avoid interpreting the entire world through only your own experiences. Just because you are okay with needles doesn’t mean everybody else could/would/should be. For example, as a former Army field medic, I’m just not grossed out by anything anymore… seriously. And it really doesn’t make a difference if I’m eating either. But… I recognize that not everybody feels the same way and I try to save the “icky” discussions for more appropriate times. 

    Who? Who prefers a higher risk of pregancy to having an implant under their skin?

    Paranoid people? :) Again, it really didn’t make a difference to me, but having talked about this with quite a few women, not everybody feels the same way. Where it’s placed under the skin, you can’t even see it if you’re not looking for it. But, if you push on the ends it pokes up like a matchstick and I’ve amused myself a few times grossing people out :)

    Why is the largely unfairly-gained reputation of Norplant a reason to not use Implanon?

    Because not everybody makes decisions based on logic and because this is how the human cognitive process works. Stereotypes, attributional biases, etc. And because FEAR is a rather powerful mental block. Hell, the fear of blood clots within some communities is more enough to prevent some women from taking the pill. Similarly, plenty of parents jumped on board the “OMG immunizations cause autism” bandwagon, and didn’t get their children immunized. Thus, some have needlessly increased the risk of their child contracting a preventable, communicable disease and some states have now been documented increases in childhood cases of things like whooping cough. It may not be fair to Implanon, but it is a hurdle they’re going to have to jump. 

    How so? The evidence that I have seen from the UK indicate that Implanon is a relatively inexpensive form of contraception, as long as the users do not discontinue prematurely.

    Yay for the UK! But it’s honestly difficult to judge costs between countries, particularly when one country has socialized medicine and the other has the furthest thing from it. All things considered, it’s about the same cost as average-priced birth control pills over the course of the three years, the major difference is that the cost is all up front instead of spread out. Think of it this way, it’s generally cheaper to buy things in bulk (diapers, cigarettes, etc.) but if you’re on a limited income, this isn’t always possible. 

    You use Implanon?

    Yep! I got it put in about seven months ago and I’m a really big fan. Between the stress and pace of grad school, my ADHD, and having an infant (who I conceived while on the pill), I was REALLY looking for a long(er) term method of birth control that I didn’t have to think about or remember. Considering my academic career goals, my personality, and in joint decision with my husband, I’d like to stay “one and done.” I would have genuinely considered a tubal, but good luck trying to convince a doc (or the insurance company) to do it before the age of 30. I responded well to Depo in high school, but it can cause calcium loss so it isn’t a great long term option. And truthfully, I’m just a little skeeved out by the idea of IUDs and NuvaRing. Plugging my cervix with a metal rod for five years or leaving plastics in my vag for a month at a time just isn’t appealing at all. Based on all of that, my provider recommended Implanon :)  Honestly, I’d prefer to NOT be on hormonal birth control at all (because there ARE side effects) and I’m hoping that my husband will agree to a vasectomy before the implant is ready to come out ::crossing fingers::

  • squirrely-girl

    I think Planned Parenthood is deliberately seeking to keep women uninformed about Implanon because they know that it has the potential to ruin the company’s abortion business.

    Considering PP inserts IUDs, I honestly can’t imagine this to be the case.

  • arekushieru

    And SG said nothing about dictating what method of birth control one should use….

  • sweetchild92

    Don’t be dense. They don’t seek out to get women pregnant against their will. Most of their services are not abortion related. What do you want them to do? Spend money on a massive implanon campaign? Do they even have the resources? I doubt it. And you have no idea whether they speak with patients one on one about their options. I bet they’re a lot better about that than some private doctors, actually. And in America, many women do face a huge issue with paying for implanon or and IUD up front. There are, most likely, many, many women who DO want these options, but cannot pay for them. And what about providers who don’t even offer these other options? Women deserve all the information possible, but not all of us are getting it.

  • sweetchild92

    As Arekushieru pointed out, that’s not the issue. There are also many who don’t. And even those that do need to offer it to their patients, because not all patients have access to info about implanon and IUDs. My experience speaks for itself-not once have I been offered anything other than another pill. Would these doctors prescribe nuvaring, implanon, depo, give me an IUD? I don’t know-and if I didn’t know about those options, I wouldn’t be able to ask, and wouldn’t know if they were available to me. These providers have a responisbility to make sure their patients know all their options and can choose the best one for them.

     


  • grayduck

    These providers have a responisbility to make sure their patients know all their options and can choose the best one for them.

     

    With that I agree.