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Frederick R. Jelovsek MD, MS "I have been taking birth control pills for about six months now. I am thrilled at the idea of not becoming pregnant, however, my problem is tremendous weight gain as a result of water retention. I have experienced no increased appetite, however my breasts are a full cup size larger and I feel that I have an added layer onto my body that makes me very uncomfortable. Is there anything that obesity and symptoms obesity and symptoms can be done about this problem?" Anon Before we know if there is any way we can treat weight gain associated with oral contraceptives, we need to know if birth control pills cause fluid retention and by what mechanism, do they cause increased appetite and how, and do they cause temporary or long term weight gain by those or any other mechanisms? With studies of recent low dose oral contraceptives, the whole premise as to whether there is any cleansing diets obesity and symptoms change in weight at all with beginning oral contraceptives is in question (1). This and other studies indicate that, on the average, women do not gain weight because of the pills. Remember this means that if 5-10% of women report weight gain when starting oral contraceptives, there is an identical 5-10% of women who gain weight even though they did not get active birth control pills. In other words the weight gain with pills was coincidental aikens diet obesity and symptoms but