Jim Shelton's Pearls

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June 24, 2003

To Tell or Not to Tell, OCs and Weight

This weight gain issue gives our program a thorny counseling dilemma. On the one hand the best science is telling us that OCs have no effect (or at most very little effect) on weight on average. On the other hand, many women still perceive a weight gain. We also know that a key determinant of success in contraceptive use is discussion of side effects. What should we say in counseling?

In my view something like what you just said makes a lot of sense, recognizing counseling should be tailored and flexible. For example: "On average pills don't cause weight gain. However as an individual, you might experience some modest weight gain or loss. Would that be important to you?"

(You might then tailor the discussion to include: some reassurance about the medical significance of a small change in weight, or what the client could do if a weight change actually were to occur - depending on the situation/response of the client.)

Science is reality, but perception is reality too.

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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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