Why the pill might make you fat

PAULA GOODYER

Can the contraceptive pill or Hormone Replacement Therapy (HRT) make it easier to gain weight?

Some women say they do, but science isn't so sure. The jury's still out on whether the pill increases weight and a recent review of research into HRT and weight concluded there was no evidence that HRT added any more to the extra kilos that many women gain around menopause anyway.

But research scientists Dr Vita Birzniece and Professor Ken Ho from Sydney's Garvan Institute of Medical Research have a different view.

They believe that taking added oestrogen in pill form can make it harder for women to offload fat - a problem that starts when the hormone reaches the liver.

"When women take oestrogen orally it goes directly to the liver where it interferes with the liver's ability to burn fat," Dr Birzniece explains.

"Previous research here at the Garvan has shown that it's how women take this extra oestrogen that's important - when women take HRT in a patch form rather than a pill, the extra oestrogen bypasses the liver and doesn't affect fat burning - for this reason women are better off taking HRT in the form of a skin patch."

So how does extra oestrogen make it harder for the liver to burn fat? Garvan researchers believe it blocks the action of another hormone that helps keep our weight in check - human growth hormone or hGH.

Not only do we need hGH to help us to burn fat and take it out of the liver, we also need it to stimulate another hormone - called IGF-1 - that helps our muscles to grow.

This means that extra oestrogen taken orally as a pill exerts a double whammy. It makes it harder for the body to get rid of fat, but also easier to lose muscle - and that's a recipe for weight gain, says Dr Birzniece who's now doing more research into fat metabolism in the liver.

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Why the pill might make you fat