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There is a myth that oral contraceptive pill (OCP) use increases body weight. The objectives of this exploratory study were to examine the relationship between OCP use and perceived weight and to test whether OCP ever use moderates the relationship between measured body mass index (BMI) and perceived weight. The sample included 6,897 females aged 20 to 49 from the 2007 to 2018 National Health and Nutrition Examination Surveys (NHANES). Perceived weight was the dependent variable; OCP ever use and measured BMI were independent variables. Covariates included socioeconomic variables and perceived health. In a crude model, the odds of participants perceiving themselves as overweight relative to perceiving themselves as “just about the right weight” were 40.4% higher for each 1-unit increase in measured BMI. In an adjusted model, participants had 40.6% greater odds of having overweight self-perception compared to “right weight” with every 1-unit increase in BMI and OCP ever users had 35.9% higher odds of overweight self-perception compared to “right weight” than never users. OCP moderates the association between measured BMI and perceived weight. In stratified models, OCP users had 44.6% higher odds of overweight self-perception, while never users had 33.6% higher odds of overweight self-perception compared to “right weight” self-perception for every 1-unit BMI increase. OCP use moderates the relationship between measured BMI and perceived weight. For two women with different OCP use history and the same measured BMI, the ever OCP user has 11% higher odds of perceiving herself as overweight compared to the never user.

Exploring Oral Contraceptive Use and Perceived Weight Among Women Aged 20 to 49 in the United States