Michigan State University psychologists say your choice of birth control could affect your Binge Eating Disorder. In a prospective cohort study published recently in the journal JAMA Network Open, doctors explain how they linked the monophasic combined oral contraceptives to emotional eating and binge eating. The good news is that the monophasic combined oestrogen and progesterone pill is just one option among many types of hormonal birth control pill.
According to the researchers, led by Kelley Klump, PhD, the combined pill triggers emotional eating and binge eating, regardless of whether you have an underlying binge eating disorder.
The team followed over 400 women over two pill cycles to see how many binge eating episodes they had when they used the active pill versus when they switched to the last week of the pack’s reminder pills. They found that the women were more likely to report emotional eating during the 21 days when they were using the combined pill versus the seven days when they took their inactive pills. The difference was significant, they claim, and happened in women with a Binge Eating Disorder diagnosis as well as women who didn’t have one.
The team directly link binge eating behaviour to hormone levels generated by the combined pill. Emotional eating during the experiment, they say, was not down to changes in mood or worrying about their weight (known psychological risk factors for binge eating).
Hectic Hormones, Birth Control and Binge Eating
Monophasic combined oral contraceptives are the most common type of hormonal birth control. Of the 28 pills in a pack, 21 contain a standard dose of progesterone and oestrogen. Each one of these pills contains the same dose. The idea is to keep the levels of hormones constant throughout those 21 days, preventing the release of an egg and the thickening of the uterine lining. From day 22 of the cycle to day 28, the pills contain no hormones. The idea is to give the body a break from all that oestrogen. Most women experience bleeding during those days as their progesterone drops.
Many women use combined oral contraception to even out the symptoms they get from their hormonal cycles. Getting rid of the ups and downs of oestrogen and progesterone can help with acne, hormonal mood changes, period pains, PCOS AKA PMOS, endometriosis and more. The problem comes for women who are prone to binge eating.
Doctors have known for years that binge eating episodes often line up with stages of the menstrual cycle. Researchers have found that women eat more in the days following ovulation, and are also more likely to binge eat. What’s more, these days are when levels of oestrogen and progesterone are both high. In the days before ovulation when only oestrogen is high, women are less likely to find themselves binge eating. Women tend to eat less when their oestrogen levels alone are high. By artificially levelling out oestrogen and progesterone for 21 days out of 28, women could be setting their hormones at a level that is likely to trigger binge eating all month instead of just in the postovulatory phase.
How to Test the Effects of the Birth Control Pill on Binge Eating
The team asked girls and women signed up to the Michigan State University Twin Registry to take part in the study. They asked that volunteers be between 15 and 30 years old with no medical or genetic conditions that might affect their hormones, appetite or weight. The participants must have been using a monophasic combined pill with seven reminder pills for at least two and a half months.
The team aimed to test how taking a pill containing hormones compared to taking an inactive pill. They would use incidence of emotional eating as a measure of binge eating. To control for emotional eating as a consequence of negative affect, they would check how a participant’s mood lined up with their putative hormone levels. Finally, they planned to test whether emotional eating was triggered by an emotional reaction to negative body image.
On days 13–16 of their pill pack, each girl or woman would start filling out a nightly survey about their eating habits, mood and feelings about their body. The team based the survey questions on the Dutch Eating Behavior Questionnaire, Positive and Negative Affect Schedule and the Minnesota Eating Behaviors Survey.
Each volunteer would track her mood, preoccupation with her weight and how often they experienced emotional eating or binge eating during the time she used active pills (days 1–21 of each pack) and inactive pills (days 22–28). The study lasted 49 days across two samples. The trial started on days 13–16 to allow researchers to capture two zero synthetic hormone sessions sandwiched between periods of equal progesterone and oestrogen.
Demographic Data
The researchers recruited 422 girls and women to take part in the study. The mean age of participants was 21.95 years old. Most identified as white, followed by 6.2% identifying as African American or Black and 0.9% as Asian or Pacific Islander. Four point five per cent of volunteers identified as Hispanic or Latinx and 4.5% self-identified as mixed race. Fifty-one women had a diagnosis of Binge Eating Disorder. Their demographic information was similar to the rest of the cohort.
Overall the women who had a diagnosis of Binge Eating Disorder reported slightly more episodes of emotional eating. They were also twice as likely to say they had been concerned about their weight and had similar mood scores to women who had no diagnosis.
Monophasic combined contraceptive pills triggered emotional eating
After 49 days the researchers collated the survey responses and analysed them to see whether the hormone content of a pill was related to a participant’s mood, level of weight preoccupation and likelihood of emotional eating. They found that, on days where the women took an active pill, they were more likely to binge. They saw no association between a woman’s affect and whether they took a hormone pill or a reminder pill that day. Importantly, there was no link between hormone pills and weight preoccupation.
The only measurable and consistent change was in whether or not the binge eating happened on a day when a woman had roughly equal levels of oestrogen and progesterone or one where she was in withdrawal from both. The team concluded that this meant that the hormone levels were more likely to be causing the change in eating behaviour than mood or underlying mental health.
Women with Binge Eating Disorder showed a similar pattern to women who didn’t. They were more likely to binge on active pill days than inactive pill days and admitted to more emotional eating incidents on inactive days than their peers without a diagnosis.
The analysis was complicated by a technical problem. The researchers didn’t have enough data to allow for the step down in hormone levels. On the first day of taking the inactive pills, the hormone levels were still dropping. While overall levels drop quite fast because the synthetic hormones have a short half life, the levels of progesterone and oestrogen would still have been falling at a similar rate. This means that not all days of the inactive pill week were directly comparable.
There is a chance that this makes the difference between taking the hormones and not taking the hormones looks smaller than it should be had they conducted this study over a more cycles and accounted for the withdrawal period.
Food for Thought
Overall this study highlights how hormonal fluctuations affect our appetite and likelihood of bingeing. If you are not using any hormonal birth control, your oestrogen and progesterone are both elevated during the mid-luteal phase. This means your hormones are only likely to trigger extra emotional eating a couple of days a month. If, on the other hand, you are using a monophonic combined oral contraceptive, you are stuck in the equivalent of the midluteal phase for three out of four weeks. Women who have Binge Eating Disorder or who are concerned about emotional eating might have a harder time managing their disordered eating if they are using a monophasic combined birth control pill.
Don’t chuck out your pills just yet. If you are worried about binge eating and your birth control, take a trip to your doctor to discuss options. Monophasic combined oral contraceptives are only one type of hormonal birth control pill among many, for example, there are combined pills that have changing doses of hormones throughout your cycle and the mini-pill, a progesterone only pill.
Read the full paper here
Klump KL, Di Dio AM, Anaya C, et al. Combined Oral Contraceptive Use and Binge Eating. JAMA Netw Open. 2026;9(6):e2619047. doi:10.1001/jamanetworkopen.2026.19047
