June 11, 2003 More on OCs and Weight Gain
 The information you gave in your last Pearl (that OCs have little or no effect on weight) caused quite a commotion among our clinic staff. Many of us have ourselves experienced weight gain on the pill or know someone else who has. Moreover, we have made a point of telling our OC clients that they might gain weight. How can there such a disparity between the studies and what seems so obvious?
 Good question. Here are some possibilities as I see it:
- The average doesn't represent everybody equally. It is conceivable that some women gain weight on the pill, others lose weight and others stay about the same. Those who gain weight may be more vocal.
- Cyclic changes in weight. For example some women may "retain fluid" while they are on OCs, and then lose it during the pill-free interval. Thus they have no gain over time, but nevertheless experience it as weight gain.
- Change in body shape. It is possible that OCs change weight distribution in the body, which might be experienced as weight gain (because clothes fit differently) without an actual gain in weight per se.
- We all tend to gain weight as we age. Also weight tends to fluctuate. So some may attribute that to OCs.
- The studies didn't rule out a small increase in weight. Although the "weight" of the evidence found a lack of effect on weight there is some wiggle room in the final conclusion "...but no large effect is evident."
- Some combination of the above.
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The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)
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