Early Weight Gain Predicting Later Weight Gain Among Depot Medroxyprogesterone Acetate Users

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—DMPA users (N=240) were assessed prior to initiating contraception and every 3 months for 36 months. Early weight gain was defined as over 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 vs. 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 < 0.001 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 vs. 0.08 kg/month, P < 0.001). Risk factors for early weight gain were: BMI less than 30 (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