Drugs Q & A

Does The Pill Make You Fat?

The birth control pill, commonly known as “the pill,” is a widely used contraceptive method that has been in use for decades. While it is highly effective in preventing unplanned pregnancies, it has also been the subject of numerous debates and discussions regarding its potential side effects.

There are several types of birth control pills available, each with its own hormonal formulation and method of action. These pills are typically categorized into two main types: combination pills and progestin-only pills. Here’s an overview of each type:

1.        Combination Pills:

•          Monophasic Pills: These are the most common type of combination birth control pills. They contain a fixed amount of both estrogen and progestin in each active pill, and the hormone levels remain constant throughout the menstrual cycle. Examples include Ortho Tri-Cyclen, Yasmin, and Loestrin.

•          Multiphasic Pills: Multiphasic pills vary the levels of hormones throughout the menstrual cycle to more closely mimic a natural hormonal pattern. This type of pill may be prescribed to reduce side effects or provide better cycle control. Examples include Ortho Tri-Cyclen Lo and TriNessa.

•          Extended Cycle Pills: These pills are designed to reduce the number of periods a woman has in a year by extending the time between menstruations. Some examples include Seasonale, Seasonique, and Lybrel.

•          Continuous-Cycle Pills: Similar to extended-cycle pills, continuous-cycle pills are taken continuously without any hormone-free intervals. These pills can result in fewer or no periods for some users.

2.        Progestin-Only Pills (Mini Pills):

•          Progestin-only pills contain only synthetic progestin hormones and do not contain estrogen. They are suitable for women who cannot tolerate estrogen or are breastfeeding because they do not interfere with milk production. Examples include Camila, Micronor, and Errin.

3.        Emergency Contraceptive Pills:

•          These are high-dose progestin-only pills taken as an emergency measure after unprotected sex to prevent pregnancy. Plan B One-Step and Next Choice are examples of emergency contraceptive pills available over-the-counter in many countries.

One of the concerns often raised is whether taking birth control pills can lead to weight gain. In this article, we will explore the relationship between the birth control pill and weight gain to provide you with a clearer understanding of this issue.

The Science Behind Birth Control Pills

The science behind birth control pills is rooted in the manipulation of hormones to create a contraceptive effect. These pills typically contain synthetic versions of two key female sex hormones: estrogen and progestin. These hormones are carefully formulated to mimic the natural hormonal changes that take place during a woman’s menstrual cycle. By doing so, birth control pills aim to disrupt the biological processes necessary for conception.

One primary mechanism through which birth control pills prevent pregnancy is by inhibiting ovulation. Ovulation is the release of an egg from the ovaries, a crucial step in the reproductive cycle. Birth control pills contain hormones that signal to the body that ovulation has already occurred, thereby preventing the release of an egg. Additionally, these pills cause changes in cervical mucus, making it thicker and less conducive to sperm transport. This thickened mucus serves as a barrier that hinders sperm from reaching and fertilizing an egg. Moreover, birth control pills alter the uterine lining, making it less receptive to a fertilized egg. This combination of effects creates a highly effective contraceptive method, but it also raises questions about potential side effects, such as weight gain.

Birth Control and Weight Gain: Fact or Fiction?

The notion that taking birth control pills can lead to weight gain has been a topic of concern for many women. However, scientific studies have not provided conclusive evidence to support this claim. It’s essential to distinguish between anecdotal reports and rigorous scientific research when evaluating the relationship between birth control pills and weight gain.

Some women may report weight gain while taking birth control pills, but it’s crucial to recognize that weight fluctuation is a common occurrence for many individuals, and it can be influenced by various factors, such as diet, exercise, genetics, and lifestyle. Additionally, women may begin taking birth control pills during a period in their lives when natural weight changes are expected, such as transitioning from adolescence to adulthood.

The Role of Hormones

Hormones play a vital role in regulating various bodily functions, including metabolism and fat storage. The synthetic hormones in birth control pills can potentially influence these processes. However, research findings have been mixed, with some studies suggesting a minimal impact on weight, while others report no significant difference in weight between women taking birth control pills and those not using any hormonal contraceptives.

Factors to Consider

When evaluating whether the birth control pill might affect your weight, consider the following factors:

1.        Individual Variations: Different people may react differently to the same medication. What works for one person may not work the same way for another.

2.        Hormone Type: The type of birth control pill you take can also make a difference. Some formulations have a higher estrogen content, while others are progestin-only. Talk to your healthcare provider about the best option for your specific needs.

3.        Diet and Lifestyle: Your eating habits, physical activity levels, and overall lifestyle choices can significantly impact your weight. It’s essential to maintain a healthy lifestyle regardless of whether you’re on birth control or not.

4.        Fluid Retention: Some women may experience water retention as a side effect of birth control pills, which can temporarily increase weight. This typically resolves after a few months of use.

What to do if the pill is making you gain weight

If you suspect that your birth control is causing you to gain weight, it’s important to address your concerns and take action to manage your health effectively. Here are some steps to consider:

1.        Consult Your Healthcare Provider: The first and most crucial step is to schedule an appointment with your healthcare provider, such as your gynecologist or primary care physician. Discuss your concerns about weight gain and any other side effects you may be experiencing. Your healthcare provider can help determine whether your birth control is indeed the cause of the weight gain or if there might be other factors at play.

2.        Explore Alternative Birth Control Options: Depending on your specific needs and health history, your healthcare provider may recommend alternative forms of birth control. There are numerous contraceptive methods available, including different types of birth control pills with varying hormone levels, non-hormonal options like copper intrauterine devices (IUDs), hormonal IUDs, implants, patches, and barrier methods. Your healthcare provider can help you choose a method that suits your needs and has a lower likelihood of causing weight gain.

3.        Adjust Your Lifestyle: Regardless of whether your birth control is contributing to weight gain, maintaining a healthy lifestyle is essential for overall well-being. Focus on a balanced diet and regular exercise to help manage your weight. Consult with a registered dietitian or fitness professional if needed to create a personalized plan.

4.        Monitor Your Weight: Keep track of your weight over time and any changes you observe. This can help you and your healthcare provider better understand any potential impact your birth control may have. It’s important to approach weight management with patience and realistic expectations.

5.        Consider Other Factors: Keep in mind that weight gain can be influenced by a variety of factors, including genetics, diet, physical activity, stress, and changes in hormonal balance. Discuss with your healthcare provider if there are other factors that may be contributing to your weight gain.

6.        Seek Support: If you are struggling with weight gain and it is affecting your emotional well-being, consider seeking support from a therapist or counselor. They can help you navigate the emotional aspects of weight management and provide strategies for coping with any stress or anxiety related to this issue.

Remember that individual responses to birth control can vary widely, and not everyone will experience weight gain as a side effect. Your healthcare provider is the best resource for evaluating your specific situation and helping you make informed decisions about your birth control method and overall health. Never discontinue or change your birth control regimen without consulting your healthcare provider, as this can affect its effectiveness in preventing pregnancy.


While concerns about weight gain are common among women considering or using birth control pills, scientific evidence supporting a direct link between the pill and substantial weight gain remains inconclusive. It’s important to remember that individual responses to birth control can vary widely. If you have concerns about weight changes or other side effects, consult with your healthcare provider. They can help you choose the most suitable contraceptive method and provide guidance on maintaining a healthy lifestyle that can support your overall well-being. Ultimately, the decision to use birth control should be based on your unique needs and circumstances, with weight gain being just one of many factors to consider.


Dr Chinenye Otorkpa

Dr. Chinenye Otorkpa is a Family Physician with a passion for women and children's well-being. She holds a Master's degree in International Public health from Liverpool John Moores University and an active membership in the World Association of Family Physicians (WONCA). She combines her medical expertise and global network connections to provide holistic healthcare.
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