Best Birth Control for overweight / Higher BMI Women

Medically reviewed by Sophia Yen, MD, MPH – Written by Aariyana Britton, B.Sc and Pandia Health Editorial Team. Updated on April 8, 2021

What’s the Best Birth Control for overweight/higher BMI women? 

Using birth control is a great way to take charge of your reproductive health! However, there are some factors that may impact the effectiveness of certain methods. The following article will provide information on which birth control types may be best for individuals who have a higher Body Mass Index (BMI). 

What is Body Mass Index (BMI)?

At it’s simplest form, BMI is used to determine whether a person’s weight can be classified as underweight, normal, overweight, or obese. 

Although BMI is not the most accurate measure of how “healthy” an individual is, as it does not account for muscle mass, it is a simple method that can be implemented to screen for various health conditions. For instance individuals with a BMI that falls in the overweight or obese category may be at a higher risk of developing heart disease, high blood pressure, type II diabetes, and certain caners. 

How is BMI calculated? 

BMI is calculated by dividing an individual’s weight in kilograms by their height in meters squared. The equation is written as follows: BMI = kg/m2 

Depending on the result of this equation, an individual will fall into one of the following categories:

• Underweight – BMI is less than 18.5 
• Normal – BMI is between 18.5 and 24.9 
• Overweight – BMI is between 25 and 29.9 
• Obese – BMI is greater than 30 

How accurate is BMI?

BMI does not necessarily determine an individual’s overall health because it does not measure body fat or take various lifestyle and genetic factors into account. Furthermore, it can lead to the incorrect labeling of an individual based on one number. Ideally, it should be used as just one piece of a larger puzzle in measuring one’s health status. For instance, an individual with a large muscle mass may be classified as obese based on my BMI alone, but they may not be at the same level of risk for certain diseases as an individual with a higher percentage of body fat. 

With all of that being said, it is a good idea to consider multiple factors when analyzing BMI as it relates to different health conditions. It is also a best practice to consult a doctor before jumping to any conclusions on your own. If they have concerns about your weight, they can help you create a plan to get healthier. 

Can being overweight affect your birth control? 

If an individual is considered overweight both based on their BMI and additional tests (i.e. skinfold thickness, bioelectrical impedance, or circumference scan), they should consider how their overall health may be impacted. Although there are many potential risks that correlate with being overweight, the following information will be specific to birth control effectiveness. 

In short, while every person with a uterus may have a different experience, being overweight could decrease the effectiveness of certain birth control methods. Hormones may be malabsorbed due to an excess of fat, further leading to lower the effectiveness of birth control.  Thankfully, this may not be the case with all types. Below is a list of different birth control methods and their effectiveness in individuals who are overweight. 

Intrauterine Device (IUD)

The IUD is a small device that is placed inside the uterus to prevent pregnancy. It works by changing the way sperm cells move so they can’t get to an egg. Its direct effect on the endometrium , or lining of the uterus, makes it an ideal method of contraception. It is also highly effective because there is not much to mess up – once it’s inserted, the individual can forget about it for several years unless they notice new discomfort or decide they want to have kids. Individuals with a higher BMI may be encouraged to opt for this method of contraception, as its effectiveness will not be impacted by their weight. 

Birth Control Implants 

The implant is a tube-like structure that goes under the skin of one’s upper arm and releases the hormone progestin, which prevents the ovaries (a.k.a female sex organs) from dropping an egg and thickens the cervical mucus to prevent sperm from passing through. Like the IUD, this is also considered a low-maintenance method because once it’s inserted, it can provide protection for up to five years. Its effectiveness has not been found to be impacted by weight, making the implant a great option for individuals who are overweight.  

Depo-Provera

Depo-Provera (a.k.a the shot) is an injection that takes place every three months. Like the implant, it works by releasing progestin to thicken cervical mucus and stop eggs from dropping, thus, preventing pregnancy. While some studies have shown that BMI may affect the body’s absorption of hormones, the shot is still considered an effective method for individuals with a uterus regardless of their weight. The only consideration is that a longer needle may need to be used if an individual has a higher percentage of body fat to ensure that the hormones are properly injected. 

NuvaRing/Annovera 

NuvaRing and Annovera (a.k.a the ring) consist of a flexible ring that is placed inside the vagina and can be left in for three to five weeks. The ring releases both estrogen and progestin to prevent sperm from joining with any eggs. While many individuals benefit from this method, it can leave room for errors. For instance, the individual may forget to get their prescription and in turn, not get the ring in on time making it less effective at preventing pregnancy. As with the aforementioned methods, the ring has not been shown to be affected by body weight, making it a possible option for any person with a uterus. 

Birth Control Patch 

The patch is worn on certain parts of the body and releases hormones through the skin to prevent pregnancy by stopping ovulation (a.k.a the release of an egg). It is replaced once a week, but does not require the assistance of a doctor. With that said, it is important to follow the directions on the prescription (i.e. making sure the patch fully sticks to your skin) in order to yield the maximum effectiveness. This method can be effective for all individuals with a uterus regardless of weight, though individuals who are overweight may notice more spotting as a result of lower estrogen absorption. 

Birth Control Pills

The pill is a small table containing estrogen and progestin hormones (unless it’s the mini pill, which just contains progestin) that is taken once a day around the same time to prevent pregnancy. It works by stopping ovulation. While the pill can be very effective at preventing pregnancy as well as provide numerous health benefits, it leaves room for error, as it requires daily action. Additionally, it may be less forgiving for individuals who are overweight. For this reason, longer-term methods of contraception may be recommended over the pill for this population. On the other hand, for those who choose to take the pill, their doctor may recommend that they take it continuously (i.e. skip the row of sugar pills and keep taking those that contain the hormone) in order to keep hormone levels stable and reduce the risk of pregnancy. 

Barrier Methods

Barrier methods of birth control consist of those that do not involve hormones: condoms, diaphragms, spermicides, etc. These products prevent pregnancy by blocking sperm from entering the uterus (a.k.a by providing a barrier). All individuals can use these methods, regardless of weight. In fact, using a barrier method in addition to hormonal birth control provides extra protection from pregnancy as well as STIs – these are not prevented by hormonal birth control alone.  

Tubal Ligation

Tubal ligation (a.k.a getting your tubes tied) consists of a surgical procedure where both fallopian tubes are cut or blocked. Although this method can be reversed with another procedure, it is considered permanent when initially implemented, as it prevents eggs from traveling between the fallopian tubes to the uterus. Furthermore, this tubal ligation will provide protection from protection and can be a great method for individuals who are sure they do not want to have children. It is also effective for all individuals, regardless of weight. However, individuals with a higher weight may be at a greater risk of experiencing complications during the procedure due to additional health issues such as high blood pressure. 

Emergency Contraception

Emergency contraception may be used if an individual is concerned about the potential risk of pregnancy after having sex. Over-the-counter options, such as Plan B, may be less effective for individuals who are overweight and ineffective for individuals who are obese. The prescription version, or Ella, works differently and maybe more effective. The downside to this is that a doctor must write the prescription, so it may take longer to access the medication, thus, increasing the risk of pregnancy. 

What’s the takeaway?

Thankfully, there are several birth control options that can be very effective for individuals who are overweight. With that being said, it is always a best practice to consult a doctor before starting birth control or trying a new method in order to determine the right course of action for maximum benefits. Starting birth control can be a great way to take charge of your reproductive health, so do not be afraid to take the leap of faith – with doctor supervision of course! 

How can Pandia Health help?

Speaking of birth control, don’t forget to check out Pandia Health’s FREE delivery service. We deliver the pill, patch, and ring to all 50 states! We also write prescriptions for individuals who live in AZ, CA, CO, FL, GA, IL, MI, NV, TX, TN, PA, WA, & WY. While under the care of our expert doctors, you can be confident that your best interest is in mind. 

Disclaimer: The above information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.