Contraception Emergency – Why Plan B Manufacturers are in Big Fat Trouble

After years of advocacy work, Plan B, also known as “the morning after pill” became available over the counter to women and girls throughout the United States without a prescription. With this victory still fresh in my mind, I learn today that this success is much more limiting than we ever imagined. Surprisingly, it is not because of draconian laws being introduced through state legislatures. Rather, professor of Obstetrics and Gynecology at the University of Edinburgh, Anna Glasier, conducted a study with alarming results: Norlevo (European brand of Plan B) begins to lose efficacy in women weighing 166lbs. For women at and above 176, it is not effective in preventing fertilization.

Glasier’s research has caused Norlevo’s manufacturer, HRA Pharma, to include these finding on the package insert. However, in the United States women and girls are accessing this medication which will, for millions, have zero effect. The most popular generic medications that are available over the counter include Plan B One-Step, Next Choice One Dose, and My Way, all of which share identical chemical and dosage makeups to its European counterpart. However, these popular generic medications are not able to disclose this new, vital  information.

According to the Food and Drug Administration, generic medication manufacturers can only alter product literature if and when the brand manufacturer has done so. As of late Monday evening, the FDA reported to Mother Jones, who broke the story, that they are looking into  whether or not they will require American manufacturers of emergency contraception pills to update their labels.

While I applaud the FDA’s quick acknowledgement of the issue, adding a new weight limit does not solve the problem. In America, the majority (69%) of adults 20 and older are considered to be overweight (BMI over 25). Further, approximately half of them are further classified as obese (BMI over 30). According to our own Health and Human Services Department, 62% of women 18 and older are overweight or obese. With so much of the population outside of the indicated weight range, myself included, one must wonder what other medications the overweight majority is being prescribed, only to expect little or no effectiveness.

In looking at birth control and oral contraceptives alone, testing is not done on women whose BMI exceeds 125% of her optimum weight. We don’t know if our own birth control pills are effective. This should be a startling realization, considering that during reproductive age, 17.1% of women (15-44) are on an oral contraceptive. They represent the majority of all contraceptive users in America (27.5%). Is it skinny bias? Fat phobia? As a, shall we say, person of size, I can tell you first hand that the medical community, by and large (get it, large!) view obesity as a non-medical issue that greatly impacts health. It is about lack of self control, laziness, etc. How, then, are we as a community, supposed to look at an entire class of medications as being not for us? For me, it is a slap in the face. Was it that these studied didn’t have anyone over 125% of their optimum weight, or did those people not matter? The numbers are clear, these women exist and they are on oral contraceptives.

This isn’t a new, emerging trend. Sadly, it is a long, nuanced belief held among thousands of American-based doctors. If we as a nation are obese, our doctors and pharmaceutical companies need to make medication for all people, not those deemed to be of a socially acceptable size.