Claim: TikTok user claims Plan ‘B’ pills and emergency contraceptives do not work for women over a 155 lbs weight.
Mostly True. An Obstetrician Gynaecologist and a lecturer at the University of Ghana Medical School, Dr Titus Beyuo, has also confirmed that women with high Body Mass Index (BMI) risk getting pregnant even when they use the emergency contraceptives. A World Health Organisation meta-analysis has also found that women with BMI more than 30kg/m² can be pregnant after taking emergency pills.
Full Text
Some social media users on TikTok have claimed that emergency contraceptives are less effective in women who have a higher weight or body mass index (BMI) above 30 kg/m².
A TikTok user, @brittniemars, wrote on a video posted on her timeline that “I took a Plan ‘B’ pill 10 hours after sex with my ex (at the time) and still got pregnant with twins and later found out Plan ‘B’ loses its effectiveness if you’re over 155lbs.”
Her post, at the time of writing this report, had received 12.3k reactions from some of her followers.
While some shared their experiences affirming the claim, others had contrary opinions, insisting that despite their weight, the contraceptives worked for them.
These have generated conversations and debates over whether or not emergency contraceptives are reliable in heavier women.
Verification
A study conducted to assess the effectiveness of emergency contraceptives in heavier women found that there are significant drops in the efficacy of the drugs in women with higher weight as compared to their colleagues who had lesser weight. Out of the 1731 population, 38 women were reported pregnant after the trial.
“Women for whom levonorgestrel was not effective in preventing pregnancy had a significantly higher mean body weight and BMI than women who did not become pregnant (76.7 vs. 66.4 kg, p<.0001; 28.1 vs. 24.6 kg/m2, p<.0001).
“The estimated pregnancy rate increased significantly from 1.4% [95% confidence interval (CI): 0.5%–3.0%] among the group of women weighing 65–75 kg to 6.4% (95% CI: 3.1%–11.5%) and 5.7% (95% CI: 2.9%–10.0%) in the 75–85 kg and > 85 kg groups, respectively,” portions of the research read.
Similarly, a 2011 research found that “risk of pregnancy was more than threefold for obese women compared with women with normal body mass index.” This study also corroborates the assertions made by the TikTok users about the medications’ effectiveness relative to weight. It means for women who weigh 155 pounds or more, ‘morning-after’ pills may not help them avoid a pregnancy.
In a conversation with Dubawa, a Consultant Obstetrician Gynaecologist, Dr Titus Beyuo, affirmed the claim and added that there are studies which have confirmed that women whose body mass index (BMI) are more that 30kg/m² have a higher risk of pregnancy compared with women whose BMI are below 25kg/m².
He, however, noted that the reduced effectiveness does not mean the emergency contraceptives do not work entirely, adding that sometimes pharmacists and doctors should calculate the weights of patients to determine the exact dose one may need for the drug to function well in their system.
The Ghana Medical Association (GMA) General Secretary explained that “if you use the BMI, people with a very high BMI have some risk of failure; the failure rate may be higher but it doesn’t mean that it doesn’t work. For women who are very obese, there is a risk of failure.”
“It depends on the types but the higher your BMI is above normal, then there is an increased risk of failure. Those who dispense the drugs know it. There is some protection; it’s not absolutely as if there is no protection.”
“Most drugs are done according to a body weight; so, when you are completely out of that body weight, then the effectiveness will not be exactly the same as somebody who is at the weight at which the studies were done,” he told Dubawa.
Meanwhile, data from 6,873 women in four WHO-HRP randomised trials between 1993 and 2010 to evaluate pregnancy rates across different weights and BMI categories saw an increase in pregnancy rates among obese womne. This is because BMIs that were over 30kg/m² decreased the efficacy of the contraceptives.
“Pregnancy rates were also low in women weighing over 80kg (0.7%) and who were obese (BMI over 30kg/m2) (2.0%). Sensitivity analyses excluding that site showed that obesity was no longer a risk factor.
“However, the other studies included too few obese women in the sample to exclude a substantial decrease in efficacy,” part of the study result read.
Who can use emergency contraceptives?
The World Health Organisation (WHO) has explained that there are no medical restrictions for persons who wish to apply any emergency contraceptive; however, individuals who want to apply any of such Plan ‘B’ pills must seek advice on appropriate contraceptive options.
A 2021 publication by the health body warned that “frequent and repeated use may be harmful for women with conditions classified as medical eligibility criteria (MEC) category 2, 3 or 4 for combined hormonal contraception or Progestin-only contraceptives (POCs).
While acknowledging that such safety pills are less effective in women whose body mass index is more than 30kg/m², the WHO was quick to add that such women should, however, not be denied free access to the emergency contraception when they need it.
Conclusion
Claims suggesting emergency contraceptives are less effective in women with body mass index above 30kg/m² are mostly true. Various studies have found that although Plan ‘B’ pills provide some form of protection against unplanned pregnancy, there is a significant drop in the efficacy of the medication with increasing body weight which induce higher pregnancy risks. A lecturer at the University of Ghana Medical School, Dr Titus Beyuo affirmed the claim, saying women with high Body Mass Index (BMI) risk getting pregnant even when they use the emergency contraceptives.
