Birth control pills tied to more binge eating

Clinical takeaway: Combined oral contraceptives may heighten emotional eating in some women during active-pill weeks; consider it when counseling patients with eating-disorder histories or unexplained eating changes.

Decades of research have tied natural ovarian hormones to binge eating, with risk peaking when both estrogen and progesterone are high. But that evidence came almost entirely from natural menstrual cycles, leaving open whether the synthetic hormones in combined oral contraceptives carry the same signal. A new daily-diary study suggests they may, at least for emotional eating, and that the effect is specific enough to point at the hormones themselves.

Combined oral contraceptives are the most commonly prescribed hormonal contraceptive, and their standard pack pairs three weeks of active estrogen-progestin pills with one hormone-free week. That design mimics the post-ovulatory phase, when estrogen and progesterone are both elevated and binge-type eating tends to climb. Because binge eating disproportionately affects women and travels with depression and substance use, whether these pills nudge that risk is a real clinical question.

Emotional eating ran higher during active hormone pills than inactive ones across both pill cycles in the full sample of 422 women, and the gap held after accounting for daily negative mood. Weight preoccupation as a control showed no such pattern, which is what makes the signal look hormone-specific rather than a general distress effect. The effect also appeared in the 51 women with a history of clinical binge eating, though it reached significance only in the second cycle, not the first.

Researchers followed 422 women, aged 15 to 30, from the Michigan State University Twin Registry, all on monophasic combined oral contraceptives, who logged emotional eating, weight preoccupation, and mood each evening for 49 straight days. Because the comparison was within each woman across her own active and inactive pills, the design sidesteps the between-person confounders that muddy most contraceptive studies.

"These findings are important for highlighting the potential negative impact of combined oral contraceptives in women. Nonetheless, it's important to note that not every woman in the study developed binge eating," said Kelly Klump, PhD, lead author and a professor of psychology at Michigan State University.

She concluded, "Future studies are needed to better identify who is at risk and inform personalized medicine approaches to women's health."

Source: Klump KL. JAMA Netw Open. 2026 Jun 17. Combined Oral Contraceptive Use and Binge Eating