Yes, birth-control pills can make you hungrier. Together, estrogen and progestin create a potent hormonal cocktail that can trigger your appetite, whether they’re naturally created by your body or consumed in pill form. But are oral contraceptives associated with binge eating? According to a new study published today in JAMA Network Open, the answer is yes. 

Psychologists from Michigan State University recruited 422 women who were currently taking oral contraceptives in packets that included inactive pills. This week-long run of placebo pills allowed for a sort of natural control condition, allowing the researchers to determine how the eating behavior changed in individuals under the sway of synthetic hormones. The participants also completed a questionnaire each evening designed to measure emotional eating (binge eating in response to negative emotions). 

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Over the study period of 49 days, they found emotional eating tended to increase when the women were taking contraceptives. According to the researchers, because ovarian hormones are powerful regulators of our brain’s dopaminergic and opioid reward systems, they drive our desire for the kinds of delicious foods typically consumed during binge-eating sessions.

While researchers say the findings highlight the negative impact birth control can have for women struggling with binge eating, they stress that not all women respond to the hormones the same way. “It’s important to note that not every woman in the study developed binge eating—they are safe for many women, and it’s likely that the risk is targeted to those with other risk factors,” study author Kelly Klump of Michigan State University said in a statement.

Interestingly, the team also discovered that emotional eating decreased during the second contraceptive cycle of the study. The researchers believe the act of self-reporting their eating activity and attitudes each night—a commonly used intervention for binge eating—may have played a role in curbing the behavior. 

“We found that self-monitoring was an effective tool in mitigating risk for women in the study,” Klump said. “The more we can equip women with tools and educate medical providers about these risks, the more effective care can be given.”

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Lead image by Tasnuva Elahi; with images by sahadhat and ita / Adobe Stock