Do birth control pills make you gain weight?

What the evidence says

The hard part with weight is that most adults gain some over the years, with or without pills. So asking people "did you gain weight on the pill?" cannot answer the question. Only trials that compare pills with a placebo, or with another method, can.

A Cochrane review pulled those trials together for combined pills (estrogen plus a progestin, like Trust, Lady and Diane-35). It concluded that no large effect on weight was evident. ^[src] The NHS puts it plainly: there is no evidence that taking the pill makes you put on weight. ^[src]

That does not mean no one ever gains weight while on the pill. It means that, on average, people on the pill did not gain clearly more than people not on it.

Why it can feel like the pill

• Fluid retention and bloating. Some people feel puffy or notice tighter clothes in the first months. This is water, not fat, and it usually settles. ^[src]
• Appetite. Some people feel hungrier at first. Filipinas on Reddit trade notes on which pill felt "hindi nakakataba" and which made them hungrier. ^[src]
• Life changes at the same time. Starting pills often lines up with a new relationship, a new job, or the months after giving birth. All of these affect weight.
• Breast tenderness or fullness. Common at first and usually settles. ^[src]

By brand

These are the brands Filipinas most often ask about. Trials mostly studied combined pills as a group rather than each brand, so the answer is similar for all the combined pills below.

Trust

Trust (levonorgestrel + ethinylestradiol, with iron tablets) is a combined pill and costs from ₱59.50 a pack. The brown tablets in the pack are iron, not hormones, and do not cause weight gain. The combined pill evidence applies. ^[src]

Lady

Lady (levonorgestrel + ethinylestradiol) is a combined pill from ₱53.25 a pack. It has a slightly higher progestin dose than Trust, but no trial we know of shows that this changes weight. ^[src]

Diane-35

Diane-35 (cyproterone acetate + ethinylestradiol) is a combined pill used mainly for acne and from ₱695.75 a pack. Some users report bloating early on. As a combined pill, the same evidence applies. ^[src] Its same-formula brands Althea and Cybelle cost less; see same formula, cheaper brand.

Daphne

Daphne (lynestrenol) is a progestin-only pill, popular while breastfeeding, from ₱161 a pack. The Cochrane review above covers combined pills, not progestin-only pills. [TODO: source: Cochrane review of progestin-only contraceptives and weight (Lopez et al.)] Moms on Reddit discuss weight in Daphne reviews, but weight also shifts a lot after giving birth. ^[src]

Micropil

Micropil (norethisterone + ethinylestradiol) is a combined pill from ₱80.50 a pack. "Nakakataba ba ang micro pills?" is a common search, and the combined pill evidence applies here too. ^[src]

The exception: the injection (DMPA)

The 3-monthly injection, DMPA (sold as Depotrust and Lyndavel), is different. It is the one method with evidence of weight gain in some users. [TODO: source: DMPA weight gain (ACOG/FSRH)] Fertility can also take up to about a year to return after the last shot. ^[src] If weight matters a lot to you, raise this with your doctor before choosing it. See the injectable guide.

What to do if you think the pill made you gain weight

1. Give it about 3 months. Early side effects like bloating often settle. ^[src]
2. Track it. Weigh yourself at the same time of day once a week and note appetite and bloating. Our side effect tracker keeps it on your phone and makes a summary for your doctor.
3. Talk to a doctor about switching if it still bothers you. Switching brands is a normal next step. Do not stop pills mid-pack without a plan, or you could get pregnant.
4. Consider a non-hormonal option like the copper IUD if you want to rule hormones out. See Find my method.