In Other Words #2

Let’s talk contraception, shall we?

I’ve been seeing some articles published in the past few years that address weight gain associated with contraception in women. Is the weight gain real or perceived? Does the fear of weight gain lead to incorrect use and/or lack of use?

There have been soooo many studies looking at birth control and weight gain. And there’s evidence contrary to what we’ve all been told at some point — that the hormones will cause us to gain weight and/or bloat.

What moved me to discuss this now was an article published online yesterday in Women’s Reproductive Health. I will spare you some of the acronyms and statistics and focus on the conclusion that actually surprised me. Women on a birth control pill are more likely to think they are overweight compared to women with the same BMI that have not taken the pill. What’s BMI? Body Mass Index – a height and weight calculation and (sometimes questionable) measure of health. So 2 women have the same measure of health, but the one taking birth control pills is more likely to think she is overweight, even if she isn’t.

[Oral contraceptive pill (OCP)] use moderates the relationship between measured BMI and perceived weight. For two women with different OCP use history and the same measured BMI, the ever OCP user has 11% higher odds of perceiving herself as overweight compared to the never user.

Smith & Harris, Exploring Oral Contraceptive Use and Perceived Weight Among Women Aged 20 to 49 in the United States, Women’s Reproductive Health 2022

Along these lines, a US study published last year revealed that women with more “body appreciation,” or what we may call body positivity, are more likely to stay the course with birth control. These users had less concern with the possibility of gaining weight, so that didn’t cause them to stop use as often as women with less body appreciation.

I think the kicker here for me has less to do with the science and hormonal profiles (shocking, I know) and more to do with the perceptions of our own bodies and what “healthy” looks like. Body positivity is somewhat of a buzz phrase at the moment, but there is something to be said for women being able to actually define healthy for ourselves. It will look different for each of us and it’s never too late to really sit back and evaluate what you’re willing to do to be sexually, physically, mentally, and emotionally well.

Very curious to get takes on this topic, as I’ve struggled with body changes from the full array of contraceptive options. Share your experiences in the comments.