A large longitudinal study examined whether hormone exposure from combined oral contraceptives is associated with changes in emotional eating.
Hormonal birth control is widely used, but its effects can extend beyond pregnancy prevention. New research suggests that, for some women, the active hormone pills in combined oral contraceptives may also influence eating behavior.
In a Michigan State University study, women reported more emotional eating while taking active pills than while taking the inactive pills included in the same contraceptive pack. The increase did not occur in every participant, and the findings do not show that oral contraceptives cause binge eating in all users.
The study is the first large-scale investigation to track changes in binge-related symptoms across active and inactive pill days.
A Built-In Comparison Within Each Pill Pack
Researchers followed 422 women from the Michigan State University Twin Registry who used combined oral contraceptives. These medications contain synthetic estrogen and progestin.
Most combined pill packs include active pills that deliver hormones and inactive, hormone-free placebo pills. That structure allowed the researchers to compare each woman’s eating behavior during periods with and without synthetic hormone exposure.
For 49 consecutive days, participants reported symptoms of emotional eating. This refers to overeating in response to negative emotions. It overlaps with binge-related behavior, although it is not necessarily the same as a diagnosis of binge-eating disorder.
Emotional Eating Rose During Active Pill Use
The study, published in JAMA Network Open, found that emotional eating was significantly higher on active pill days than on inactive pill days.
The pattern appeared across the full group and among women who had a current or past history of clinically significant binge eating. This suggests that the effect was not limited only to participants with a known history of severe symptoms.
Previous research has suggested that ovarian hormones (natural estrogen and progesterone) can affect binge-eating risk in females. The new findings indicate that synthetic hormones in combined oral contraceptives may also play a role.
The results apply specifically to combined oral contraceptives. They should not be assumed to apply to every form of hormonal birth control, including progestin-only pills, implants, injections, hormonal IUDs, or other methods that deliver hormones differently.
Some Women May Be More Vulnerable Than Others
“These findings are important for highlighting the potential negative impact of combined oral contraceptives in women. Nonetheless, it’s important to note that not every woman in the study developed binge eating — they are safe for many women, and it’s likely that the risk is targeted to those with other risk factors,” said Kelly Klump, lead author of the study and MSU Research Foundation Distinguished Professor in MSU’s Department of Psychology. “Future studies are needed to better identify who is at risk and inform personalized medicine approaches to women’s health.”
The researchers also found that daily reporting of binge-eating symptoms, a practice known as self-monitoring, was linked to lower levels of binge eating among participants. The reduction continued even when women were taking active hormone pills.
“We found that self-monitoring was an effective tool in mitigating risk for women in the study,” said Klump. “The more we can equip women with tools and educate medical providers about these risks, the more effective care can be given.”
The researchers hope that greater awareness of the possible connection between combined oral contraceptives and binge eating, along with the benefits of self-monitoring, will help medical professionals provide more personalized care to women who may be at higher risk.
Reference: “Combined Oral Contraceptive Use and Binge Eating” by Kelly L. Klump, Alaina M. Di Dio, Carolina Anaya, Megan E. Mikhail, S. Alexandra Burt, Cheryl L. Sisk, Pamela K. Keel, Debra K. Katzman, Michael Neale, Lindsay S. Ackerman, Shaunna L. Clark and Kristen M. Culbert, 17 June 2026, JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2026.19047
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