Weight gain on the combined pill--is it real?

Britain has one of the highest teenage pregnancy rates in Western Europe at 8.8 per 1000 live births. Adolescents are very preoccupied with body image and fear weight gain with use of the combined oral contraceptive (COC) pill. Compliance with contraception continues to be a major issue. Is there a real evidence of weight gain? Or are there discrepancies between adolescent perceptions of weight gain with COC use and available scientific evidence? We carried out a comprehensive literature search and did not find evidence for the purported weight gain with use of low dose COCs. Adolescents need reassurance by gynaecologists, general practitioners, family planning doctors and mass media to remove such misperceptions. This will contribute in some way to reduce the high unintended pregnancy rates.