Early weight gain predicting later weight gain among depot medroxyprogesterone acetate users

Abstract

Objective: To examine if early weight gain in depot medroxyprogesterone acetate (DMPA) users predicts continued excessive weight gain and to identify risk factors of early weight gain in DMPA users.

Methods: Depot medroxyprogesterone acetate users (N=240) were assessed before initiating contraception and every 3 months for 36 months. Early weight gain was defined as more than 5% baseline weight gain within 6 months of DMPA use. Mean weight gain at 6-month intervals was estimated based on early weight gain status (at or below 5% gain compared with above 5% gain). Multiple logistic and mixed-model regression analyses were used.

Results: About one-fourth of DMPA users had early weight gain. The mean weight gain of the at or below 5% group and above 5% group was 0.63 kg and 8.04 kg, 1.48 kg and 10.86 kg, and 2.49 kg and 11.08 kg after 12, 24, and 36 months (P<.001 at all observations), respectively. Early weight gainers also had a much steeper slope of weight gain over time than the regular weight gainers (0.35 kg/month compared with 0.08 kg/month, P<.001). Risk factors for early weight gain were body mass index less than 30 (odds ratio [OR] 4.00, 95% confidence interval [CI] 1.513-10.455), parity (OR 2.23, 95% CI:1.040-4.761), and self-reported increased appetite after 6 months of DMPA use (OR 3.06, 95% CI 1.505-6.214).

Conclusion: Most DMPA users who gain excessive weight experience more than a 5% weight increase within 6 months. These data help physicians predict who is at risk of excessive gain and counsel them appropriately.

Level of evidence: II.

Figure 1

Mean weight gain at 12, 24, and 36 months by weight gain status at 6 months. Differences* were significant at the P < .001 level using Mann-Whitney U test.