Objective: To identify risk factors for weight gain and explore body composition and eating behaviors among adolescent females initiating depot medroxyprogesterone acetate (DMPA).
Methods: A longitudinal study was conducted in 43 adolescent females beginning DMPA. Data collection at baseline, 3, and 6 months included structured interview; measurement of height, weight, and percent body fat; and assessment of dietary restraint, disinhibition, and appetite.
Results: Black and white subjects did not differ in baseline weight or body composition. At 6 months, black subjects had a 4.2% increase in weight (mean weight gain=2.9 kg; P=0.003) and a 12.5% increase in body fat (mean fat gain =2.5 kg; P<0.001). In contrast, white subjects had a 1.2% increase in weight (mean weight gain=0.9 kg; P=0.32) and a 1.2% increase in body fat (mean fat gain of 0.5 kg; P=0.54). Baseline weight (P<0.001), study visit (P=0.005), age (P=0.006), eating restraint (P=0.005), eating disinhibition (P<0.001), and other medications (P<0.001) were predictive of weight gain in black subjects. Only baseline weight (P<0.001) was predictive in white subjects. Higher baseline weight (adjusted odds ratio (AOR)=1.2, 95% confidence interval (CI)=1.1,1.3) was a risk factor for gaining >2.2 kg the first 3 months. Black race (AOR=7.8, 95% CI=1.5, 66.2) and younger age at menarche (AOR=0.6, 95% CI=0.3, 0.9) were risk factors for gaining >2.2 kg the second 3 months. Appetite decreased in the study sample reaching statistical significance in black subjects.
Conclusions: Our data suggest that black and white adolescents differ in the quantity, timing, and predictors of weight gain on DMPA. DMPA-associated weight gain is paralleled by increases in total body fat, while appetite decreases on DMPA.