Taking a New Obesity Drug and Birth Control Pills? Be Careful

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Taking a New Obesity Drug and Birth Control Pills? Be Careful

For women who are obese, daily life is wrought with landmines. Whether it’s the challenges of air travel because plane seats are too small, the need to shield themselves from the world’s discriminating eyes, or the great lengths many will go to achieve better health and the promise of longevity, navigating life as an obese person requires a thick skin.

So, it’s no wonder so many are willing to pay more than $1,000 a month out of pocket to get their hands on drugs like semaglutide (Ozempic and Wegovy) or tirzepatide (Mounjaro). The benefits of these drugs, which are part of a new class called GLP-1 receptor agonists, include significant and rapid weight loss, blood sugar control, and improved life quality; they are unprecedented in a setting where surgery has long been considered the most effective long-term option.

On the flip side, the desire for rapid weight loss and better blood sugar control also comes with an unexpected cost. Many women living with obesity who take oral contraceptives are unaware that these drugs – especially Mounjaro – can interfere with the absorption of birth control pills and how well they work, making an unintended pregnancy more likely.

Roughly 42% of women in the U.S. are obese, 40% of whom are between the ages of 20 and 39. Although these new drugs can improve fertility outcomes for women who are obese (especially those with polycystic ovary syndrome, or PCOS), only one – Mounjaro – currently carries a warning about birth control pill effectiveness on its label. Unfortunately, it appears that some doctors are unaware or not counseling patients about this risk, and the data is unclear about whether other drugs in this class, like Ozempic and Wegovy, have the same risks. 

“I really think that if patients want to protect themselves from an unplanned pregnancy, that as soon as they start the GLP receptor agonists, it wouldn’t be a bad idea to use condoms, because the onset of action is pretty quick,” said Kodaman, noting also that “at the lowest dose, there may not be a lot of potential effect on gastric emptying. But as the dose goes up, it becomes much more common or can cause diarrhea.” 

SOURCES:

Neel Shah, MD, endocrinologist; associate professor, McGovern Medical School, University of Texas Health Science Center, Houston.

Pinar Kodaman, MD, PhD, reproductive endocrinologist; assistant professor of gynecology, Yale School of Medicine, New Haven, CT.

Zoobia Chaudhry, obesity medicine doctor, assistant professor of medicine, Johns Hopkins School of Medicine, Baltimore.

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