Obesity is an increasingly important public health concern; in 2017, 64% of adults in England were overweight or obese and the prevalence is increasing.1 Aside from the significant associated health issues such as an increased risk of type 2 diabetes, cardiovascular disease, and several types of cancer, there are also wider implications for health. 

Women with obesity, particularly those with co-morbidities, are at significantly higher risk of pregnancy‑related complications compared with women of normal body mass index (BMI). Pregnancy planning and pre‑pregnancy optimisation of weight is therefore especially important in this group. It is essential that all women have access to appropriate contraception and related support if and when they want it.

There are, however, important considerations that need to be taken into account when prescribing a contraceptive method for women who are overweight or obese. The risks associated with raised BMI or other related co-morbidities vary between contraceptive type, making some methods more or less appropriate for this group. In April 2019, the Faculty of Sexual & Reproductive Healthcare (FSRH) published a new guideline on obesity, overweight, and contraception.

In this issue, Dr Annabel Forsythe and Valerie Warner Findlay summarise the recommendations and discuss the specific risks and benefits associated with each contraceptive type for women who are overweight or obese. Some of these risks and benefits relate directly to the woman having raised BMI, whereas others are indirect and relate to co-morbidities or other health issues where overweight and obesity are contributing factors.

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  1. NHS Digital website. Statistics on obesity, physical activity and diet, England, 2019. Part 3: Adult overweight and obesity. digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2019/part-3-adult-obesity (accessed 17 June 2019).