Combined Oral Contraceptive Pills Linked to Emotional Eating: JAMA
USA: A study published in JAMA Network Open found that active combined oral contraceptive (COC) pills are associated with an increased risk of emotional eating (EE). The findings suggest that hormonal fluctuations related to active COC use may influence eating behaviors, highlighting the importance of considering psychological and behavioral effects when prescribing or monitoring oral contraceptives. Further research is needed to clarify the underlying mechanisms and long-term clinical implications.
The study was conducted by Kelly L. Klump from the Department of Psychology at Michigan State University, East Lansing, and colleagues. The researchers investigated whether active hormone pills in combined oral contraceptives were associated with changes in binge-eating–related behaviors, particularly emotional eating, compared with inactive pills.
Previous research has shown that naturally occurring ovarian hormones can influence binge-eating risk in women. However, it has remained unclear whether combined oral contraceptives, which expose users to synthetic estrogen and progestin, have similar effects. To explore this question, the investigators conducted a longitudinal daily survey study involving women already using monophasic combined oral contraceptives.
The study included 422 women (mean age: nearly 22 years) who recorded their pill use and eating behaviors over 49 consecutive days. Researchers compared emotional eating during active and inactive pill phases within the same participants while adjusting for negative mood. A subgroup analysis was also conducted in 51 women with clinically defined binge-eating episodes.
The study led to the following findings:
- Emotional eating increased significantly during active hormone pill use compared with inactive pill use across two consecutive contraceptive cycles.
- The association remained significant even after adjusting for negative affect, indicating that the increase was not explained by changes in mood.
- A similar pattern was observed among women with clinically significant binge-eating episodes.
- Active combined oral contraceptive use may influence eating behaviors in women who are vulnerable to binge eating.
- Weight preoccupation did not differ significantly between active and inactive pill phases, suggesting the hormonal effect was specific to emotional eating rather than concerns about body weight or shape.
The researchers acknowledged several limitations, including the lack of direct hormone measurements, the inclusion of only monophasic combined oral contraceptives, and the absence of a hormone washout period, all of which may have influenced the findings. They also noted that individual factors, such as genetic susceptibility, could affect how women respond to hormonal contraceptives.
The authors concluded that active combined oral contraceptive pills are associated with an increased risk of emotional eating. They called for further research to clarify the underlying mechanisms, evaluate other hormonal contraceptive formulations, and identify women who may be most susceptible. They also suggested that self-monitoring of eating behaviors could be incorporated into contraceptive counseling to support more personalized care.
Reference:
Klump KL, Di Dio AM, Anaya C, et al. Combined Oral Contraceptive Use and Binge Eating. JAMA Netw Open. 2026;9(6):e2619047. doi:10.1001/jamanetworkopen.2026.19047
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