Weight and body mass index among female contraceptive clients

ObjectivesAs obesity may affect the efficacy of some contraceptives, we examined weight, body mass index (BMI) and prevalence of obesity among female contraceptive clients at 231 U.S. health centers. A secondary aim was to analyze differences in contraceptive method use by obesity status.Study designCross-sectional study using de-identified electronic health record data from family planning centers. We analyzed contraceptive visits made by 147,336 females aged 15–44 years in 2013.ResultsA total of 46.1% of clients had BMI ≥ 25. Mean body weight was 154.4 lb (S.D.= 41.9); mean BMI was 26.1 (S.D.= 6.6). A total of 40% had BMI ≥ 26, when levonorgestrel emergency contraception may become less effective. Obese clients had higher odds of using a tier 1 or tier 3 contraceptive method and had lower odds of using a tier 2 or hormonal method than non-obese clients.ConclusionsAbout half of contraceptive clients would be categorized as overweight or obese. Contraceptive method choices differed by obesity status.ImplicationsAbout half of contraceptive clients in this study population were overweight or obese. Contraceptive method choices differed by obesity status. All women — regardless of body size — should receive unbiased, evidence-based counseling on the full range of contraceptive options so that they can make informed choices.