All sexually active youth, whether obese or normal weight, should be offered counseling regarding contraception and appropriate contraceptive methods. However, obese youth who are sexually active may be less likely than their normal weight peers to use contraceptives correctly. Methods of contraception for obese adolescents are reviewed in this discussion. Combined oral contraceptives (COCs) and the contraceptive patch have higher failure rates in obese versus normal weight females, though failure rates are lower than noted with barrier contraceptives. The risk for venous thrombosis is higher in obese youth on COCs. Progestin-only pills and the levonorgestrel intrauterine system appear to be safe and effective methods in obese females. Depotmedroxyprogesterone acetate, intravaginal ring, and implants are also considered.
Greydanus, Donald E.; Omar, Hatim A.; and Tsitsika, Artemis, "Concepts of Contraception for Adolescents with Obesity: Pathways of Judicial Moderation" (2009). Pediatrics Faculty Publications. 137.