hi Observational studies have reported variable effects of DMPA on weight gain. Some studies found nonsignificant changes in weight among women who used DMPA for up to one year others described weight gain ranging from 3 to 6 kg or an increase in BMI . One of these studies, for example, followed 703 women (African American, white, and Hispanic) for three years after beginning use of oral contraception, DMPA, or nonhormonal contraception [46]. DMPA users increased their weight (+5.1 kg), body fat (+4.1 kg), percent body fat (+3.4 percent), and central to peripheral fat ratio (+0.1) significantly more than users of oral contraception and nonhormonal contraception. In other studies, a greater than 5 percent increase in weight during the first six months of DMPA use was predictive of higher weight gain over time with continued use (eg, 0.35 kg/month compared with 0.08 kg/month in women with It appears that large weight gain is more likely in certain subgroups, such as adolescents (especially overweight adolescents), and normal weight and overweight adult women, and less likely among obese adult women . A systematic review found that obese adolescent, but not obese adult, DMPA users gained more weight than normal weight users . However, even nonobese adolescent DMPA users appear to gain more weight than adolescent nonusers or oral contraceptive users. Weight gain on DMPA may mitigate loss of BMD among adolescent users . The weight changes reported with DMPA use in observational studies may have resulted from demographic differences in the study populations and the differing susceptibilities of these populations to weight gain. Randomized trials, although not definitive, have not reported significant weight gain in DMPA users. One randomized trial compared the effects of intramuscular DMPA and saline injections on food intake, resting energy expenditure, and body weight . DMPA did not increase appetite or weight in normal weight women observed during the two menstrual cycles before, and first menstrual cycle following, the initial injection. Two randomized trials comparing a subcutaneous formulation of DMPA and leuprolide in women with symptomatic endometriosis found no difference in the impact of these drugs on weight over 6 to 12 months of use . However, the results of these trials are not generalizable since the first trial involved only 20 volunteers who received only one injection of DMPA and the other two trials had controls whom were given leuprolide rather than another contraceptive drug or no contraceptive drug SO I THINK DEPO MEDROXYPROGESTERONE IS NOT A HIGHLY CULPRIT OF WEIGHT GAIN...YOU SHOULD DO OTHER TESTS LIKE CORTISOL LEVEL AND SO ON TAKE CARE