The study, published in JAMA Network Open, tracked 422 women taking monophasic combined oral contraceptives and collected daily reports of eating for 49 consecutive days. Using a within-person design, the researchers compared days when participants took active pills containing synthetic hormones with days when they took inactive pills that contain no hormones. A typical pack consists of about three weeks of active pills followed by about one week of inactive pills. Participants were in late adolescence to young adulthood.
The primary outcome was emotional eating, defined as overeating in response to negative emotions. Emotional eating was higher on active pill days than on inactive pill days. This pattern held across two full pill cycles, in the full sample of 422 women, and in a subset of women with diagnosed binge eating. Importantly, the difference remained after accounting for negative mood, indicating the effect was not fully explained by emotional distress.
The analysis focused on average within-person changes rather than predicting each individual's response, and the authors emphasize that responses varied across women. Other outcomes tested showed different patterns: weight preoccupation did not change across pill type, and mood changes tied to pill type were smaller and less consistent than changes in eating. The research team was led by Kelly Klump at Michigan State University, with Shaunna Clark of Texas A&M University as a coauthor.
The authors caution that the study identifies an association between periods of hormone exposure in the pill cycle and increased emotional eating; it does not prove causation. The findings extend previous work showing binge-related eating tends to rise after ovulation, when estrogen and progesterone are higher, by demonstrating a similar pattern linked to synthetic hormones in contraceptives. The authors suggest the results may help clinicians and patients consider how different hormone exposures affect eating behaviour.
Difficult words
- monophasic — Having the same hormone dose in each active pill
- combined oral contraceptives — Pills that prevent pregnancy with two hormones
- within-person — Comparing different days for the same person
- active pill — Tablet that contains hormones in a packactive pills
- inactive pill — Tablet in the pack without hormonesinactive pills
- emotional eating — Eating more because of negative feelings
- binge eating — Repeated eating large amounts with loss of control
- ovulation — Time in cycle when an egg is released
- estrogen — Female hormone that varies across the cycle
- progesterone — Female hormone that also rises after ovulation
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How might clinicians and patients use the study's findings when choosing contraceptive options? Give reasons.
- Why is it important that the researchers used a within-person design and noted varied responses across women?
- What additional evidence would make the link between contraceptive hormones and eating behaviour stronger?
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