It can be really hard to lose weight, and when you're on birth control — which is often perceived as adding pounds and pounds to the scale — the idea of slimming down can feel nearly impossible. The good news? While it's normal to gain weight on birth control, it isn't as common as you think, and the doctors POPSUGAR spoke with assured us that with time, patience, and a bit of discipline, you can tackle those weight-loss goals. Here's what you need to know before getting started.
Why Does Hormonal Birth Control Cause Weight Gain?
While some hormonal birth control methods contain estrogen, they all increase levels of progesterone in the bloodstream. And, just like natural fluctuations in progesterone can lead to bloating and weight gain in the days leading up to your period, so too can the hormones found in birth control. Progesterone is linked with water retention, Andrea Alexander, MD, FACOG, a board-certified ob-gyn in Texas and the author of Black Maternal Mortality: Our Fight Back, told POPSUGAR. "[It also] stimulates the part of the brain stem that is responsible for functions like digestion, and it increases hunger." That's why you may have cravings around your period, or notice changes in your appetite after starting birth control.
But this doesn't mean that weight gain is inevitable. Dr. Alexander explained that it's highly individual, and some methods of birth control are more likely to cause weight gain than others. Short-acting forms of birth control, such as the pill or a contraceptive patch, typically don't cause weight gain, while research has shown that long-acting, reversible methods like the Depo-Provera shot, a birth control implant, or a hormonal IUD may in fact lead to changes on the scale. In one study, the average weight gain on these methods ranged from about two pounds to just under five pounds after one year of consecutive use — an uptick Dr. Alexander described as mildly insignificant. However, she noted that Black participants were more likely to experience "significant weight gain," compared to other racial groups.
The Depo-Provera shot, a birth control implant, and a hormonal IUD are all progestin-only methods, which only underscores the connection between larger doses of progesterone and weight gain. But again, Dr. Alexander stressed that there's "no hard number of pounds that you should expect to gain on a certain method," because everyone's body reacts differently.
Does Hormonal Birth Control Make It Harder to Lose Weight?
Emily VinZant, MD, a board-certified family physician who specializes in obesity medicine and a clinical associate professor at the University of Kansas, told POPSUGAR that she often sees patients or weight-loss coaching clients who experience weight gain soon after starting hormonal birth control. That doesn't mean that a person can't be successful in losing weight, Dr. VinZant said — but it may take a few menstrual cycles for their body to acclimate to the birth control, and therefore, a few months to see progress and get a better sense of the adjustments that need to be made.
Dr. Alexander noted that, if you're someone who has always struggled to lose weight, you may continue to struggle with weight loss while on birth control, especially with long-acting methods. This is why it's important to discuss your medical history with your doctor and make a decision together about which method is right for you.
Whether or not you're on birth control, the same principles apply for losing weight — you need to eat a balanced diet and exercise regularly, Dr. VinZant said. (You know the saying: calories in versus calories out.) If you need some guidance, be sure to talk to your doctor or a registered dietitian. Dr. Alexander also suggests keeping a weight journal to help hold yourself accountable. "People who see their progress in black and white tend to fare better in losing weight and staying in shape," she said.