Dietary intake and eating behavior in depot medroxyprogesterone acetate users: a systematic review

Abstract

Because of weight gain, women often discontinue hormonal contraception, especially depot medroxyprogesterone acetate (DMPA). Our objective was to conduct a systematic review of studies describing dietary intake or eating behavior in DMPA users to understand whether the use of DMPA is associated with changes in dietary habits and behaviors leading to weight gain. We searched the PubMed, POPLINE, CENTRAL Cochrane, Web of Science, and EMBASE databases for reports published in English between 1980 and 2017 examining dietary intake or eating behavior in healthy women in reproductive age and adolescents using DMPA (150 mg/mL). Of the 749 publications screened, we excluded 742 due to duplicates (96), not addressing the key research question (638), not reporting dietary intake data (4), and not evaluating the relationship of body weight and dietary or eating behaviors (4). We identified seven relevant studies, including one randomized placebo-controlled trial, one non-randomized paired clinical trial, and five cohort studies. The randomized trial found no association and the other reports were inconsistent. Findings varied from no change in dietary intake or eating behavior with DMPA use to increased appetite in the first six months of DMPA use. Few studies report dietary intake and eating behavior in DMPA users and the available data are insufficient to conclude whether DMPA use is associated with changes in dietary habits or behavior leading to weight gain.

Type and Duration of Use of Hormonal Contraceptives as a Trigger for Maternal Weight Increase in Family Planning Acceptors in Bali: A Cohort Study

“…Individuals who use hormonal contraceptives will generally experience an improved diet. This leads to an increase in the amount of food intake, resulting in an increased risk of weight gain (Silva et al, 2018). In addition, at the beginning of use, there can be temporary fluid retention, resulting in a temporary increase in body weight (De Leo et al, 2016).…”

“…The longer the use of hormonal contraceptives, the longer the increase in appetite occurs. This situation causes the increase in food intake also lasts a long time, resulting in an accumulative increase in body weight (De Leo et al, 2016;Silva et al, 2018).…”

Depo-medroxyprogesterone acetate, weight gain and amenorrhea among obese adolescent and adult women

“…However, as the data in the current study was collected from routine gynecological DMPA visits physical activity and nutritional status data was not collected and serves as a study limitation. A systemic review by Silva et al examining dietary intake and eating behavior among DMPA users was not able to determine if DMPA contributes to changes in eating behavior which could possibly serve as an explanation for weight gain by its users [19]. Another study, though small with only 43 patients, reported that despite a decrease in appetite black adolescents gained more weight and body fat on DMPA compared to white adolescents who were on DMPA for the same amount of time, suggesting racial differences in weight gain and body composition while on DMPA [12].…”

“…Weight loss/gained was calculated (weight at study end -weight at study beginning). The gray box indicates women who were adolescents (age[16][17][18][19] at the beginning of the study. The color of the dot corresponds to the BMI category.…”