title: Weight and body mass index among female contraceptive clients.
abstract: OBJECTIVE
  As obesity may affect the efficacy of some contraceptives, we examined weight, body mass index (BMI) and prevalence of obesity among female contraceptive clients at 231 U.S. health centers. A secondary aim was to analyze differences in contraceptive method use by obesity status.
  
  
  METHODS
  Cross-sectional study using de-identified electronic health record data from family planning centers. We analyzed contraceptive visits made by 147,336 females aged 15-44 years in 2013.
  
  
  RESULTS
  A total of 46.1% of clients had BMI ≥25. Mean body weight was 154.4 lb (S.D.=41.9); mean BMI was 26.1 (S.D.=6.6). A total of 40% had BMI ≥26, when levonorgestrel emergency contraception may become less effective. Obese clients had higher odds of using a tier 1 or tier 3 contraceptive method and had lower odds of using a tier 2 or hormonal method than non-obese clients.
  
  
  CONCLUSIONS
  About half of contraceptive clients would be categorized as overweight or obese. Contraceptive method choices differed by obesity status.
  
  
  CONCLUSIONS
  About half of contraceptive clients in this study population were overweight or obese. Contraceptive method choices differed by obesity status. All women - regardless of body size - should receive unbiased, evidence-based counseling on the full range of contraceptive options so that they can make informed choices.
authors.affiliation: Planned Parenthood Federation of America, 434 West 33 Street, New York, NY, USA. Electronic address: julia.kohn@ppfa.org.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Kohn
authors.affiliation: Planned Parenthood Federation of America, 434 West 33 Street, New York, NY, USA. Electronic address: priscilla.lopez@ppfa.org.
authors.forename: Priscilla M
authors.initials: PM
authors.lastname: Lopez
authors.affiliation: Planned Parenthood Federation of America, 434 West 33 Street, New York, NY, USA. Electronic address: hannah.simons@ppfa.org.
authors.forename: Hannah R
authors.initials: HR
authors.lastname: Simons
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003270:Contraceptive Agents; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016912:Levonorgestrel; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D014481:United States; D055815:Young Adult
chemical_list: D003270:Contraceptive Agents; D016912:Levonorgestrel
keywords: BMI; Body mass index; Contraception; Emergency contraception; Family planning centers; Weight