Do birth control pills cause weight gain? A Registered Dietitian weighs in.

Key Points

• Do contraceptive pills make you gain weight? The science is still out.
• However, many women report weight gain and bloating while on birth control.
• Water retention is common in the short term but, typically, it doesn’t last.
• Weight gain is complex, and there may be many reasons why you gain weight.
• A Registered Dietitian could help you manage weight loss on birth control.

Using birth control is so common that it’s hard to grasp how groundbreaking it was initially. In the sixties, being on birth control gave women unprecedented power over their bodies with the ability to prevent unplanned pregnancies.

Oral contraceptives were so influential that they earned the right to be known by a simple moniker: ‘The Pill.’

If you’re thinking, “That’s great, but is the pill making me gain weight?” Here's the answer.

Unraveling the link: birth control pill and weight gain

Most studies show no direct connection between the pill and weight gain, but the research is still too little to conclude definitively.

In the past, birth control pills had much higher levels of female sex hormones progesterone and estrogen. Because of this, many women did gain weight.

Says Registered Dietitian Nutritionist Rita Faycurry, RD, “Many of my clients ask me, ‘Is my birth control making me gain weight?’ Fortunately, female contraceptives have evolved significantly, and pills today do not have long-term weight gain as a side effect. Any weight gain experienced is typically temporary and can last from a few weeks to a few months.”

Note: Depo-Provera, the birth control shot, is one contraceptive method that lists weight gain as a side effect. It contains a type of progestin called medroxyprogesterone acetate, which needs to be administered by a healthcare provider every three months.

So, if you’re worried about weight gain before getting on the pill, talk to your healthcare provider.

If you're already on the pill or recently changed your birth control and notice weight gain, here’s how you can lose weight while on birth control.

How to manage your weight on birth control?

1. Track your weight

If you're on the birth control pill and notice weight gain or bloating, it's important to monitor these changes and discuss them with your healthcare provider.

2. Wait a few months

Rita Faycurry, RD, notes, “In many cases, your body might just need time to adjust to the new hormonal levels, and the weight gain could be temporary. Even the temporary feeling of weight gain may be due to fluid retention that typically goes away after a few weeks to months.”

If the weight gain or fluid retention persists after 2-3 months, you could talk to your healthcare provider and consider switching to a different pill or contraceptive method.

3. Evaluate stress levels

Sometimes, when we’re focused on one change in our lives, like getting on a new birth control pill, we may not pay attention to other factors that may influence our weight gain.

For instance, around the time you got on the pill, did you:

• Move houses?
• Leave for college?
• Have more stress at work?
• Deal with grief, relationship issues, or other emotional events?
• Work on a tough decision or project?
• Start a new, strenuous workout routine?
• Face any other type of stressful situation?

It’s helpful to think about these issues because high stress means high levels of cortisol, the stress hormone, which can lead to weight gain, particularly belly fat. It can also lead you to overeat.

4. Get moving

While exercise alone does not make you lose weight (the calories-in-calories-out process is a myth), it helps boost your metabolism and get fluid and toxins out of your system.

The type of exercise and how you feel about it right after also matter. 

For example, research shows that you get hungry after prolonged, moderate exercise compared to short bursts of high-intensity workouts.

Also, if you find yourself seeking a reward after a good workout by eating high-calorie foods, it may have led to your weight gain. It’s a myth that we can eat whatever we want and burn it off through exercise.

In this case, learning to control your food cravings is helpful. Consider adding more dietary fiber and protein to your meals.

5. Review your other prescriptions: some cause weight gain

While you were on the new birth control pill, if you were also diagnosed with a mental health condition, you may be taking medication that is known to cause weight gain.

These include:

• Antidepressants: Mirtazapine (Remeron) and amitriptyline (Elavil) and long-term use of SSRIs (selective serotonin reuptake inhibitors) like Zoloft, Prozac, Paxil, Celexa, and more.
• Antipsychotics: Clozapine (Clozaril, FazaClo) and olanzapine (Zyprexa) may also make you gain weight.
• ADHD stimulants: Some ADHD meds like methylphenidate (Ritalin) and amphetamine/dextroamphetamine (Adderall) are appetite suppressants. So, when their effect wears off, you may experience intense cravings, making you binge at night.

Note: This is not a comprehensive list; each person responds to different drugs in their own way. If you feel your antidepressant or antipsychotic may be responsible for your weight gain, talk to your healthcare provider about your concerns.

It’s possible to manage your weight on antidepressants with the help of a Registered Dietitian, who can develop a personalized nutrition plan just for you. Use Fay to find a Registered Dietitian near you, covered by insurance.

6. Eat mindfully

According to Faycurry RD, it’s important to practice mindful eating to control your weight. This simply means slowing down and really paying attention to the food you’re eating.

You could start small with the following tips:

• Avoid distractions: Try to avoid eating at your desk while you work or study. The reason is, that since your brain is occupied elsewhere, you may overeat or eat too fast without realizing it. 
• Build in delays: Lay your fork down between bites and chew your food slowly.
• Start right: Avoid overloading your plate right away. Try eating smaller portions and go back for more if needed. If you’re buying packed lunches or breakfasts, it’s okay to stop eating when you’re full and eat the rest later.
• Add variety to your meals: Our brains like novelty, so consider switching up your dressings, spices, and condiments to excite your taste buds.
• Eat until you’re 80% full: Stop eating just before you’re full. If you’ve been used to the ‘full’ feeling as a sign to finish your meal, it may be time to get adjusted to this new lightness. Eventually, your body and brain will adapt.

7. Understand that it’s natural for your body to change

As we grow older, our bodies change. Female bodies, in particular, experience hormone fluctuations and changes in metabolism at various stages of growth.

Additionally, over time, you may have developed a food sensitivity that you did not have earlier, like a gluten sensitivity, lactose intolerance, or milk protein allergy that may have caused inflammation and bloating.

You may have developed insulin resistance (long before a blood test picks it up) that may be the root of your weight gain.

These are just examples; there may be many other reasons why you cannot lose weight.

Consider reevaluating what diet and lifestyle are best for your body with a fresh pair of eyes. What worked as a teenager or young adult does not always work later in life, and that’s okay.

Lose weight on birth control with help from a Registered Dietitian

Weight gain is complex and involves biological, psychological, and emotional factors. It can be overwhelming to deal with it on your own.

A Registered Dietitian could help you identify diet, lifestyle, or eating patterns responsible for your weight gain and offer tried-and-tested ways to combat weight gain and water retention.

Fay can help you find a Registered Dietitian near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.