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Although hormonal contraception has been used by millions of women worldwide since the 1960s, data about the influence of body weight on efficacy are sparse. Overweight and obesity have been theorized to influence the metabolism of these steroid hormones, thereby contributing to escape ovulation and unintended pregnancy despite good adherence. To determine whether high body-mass index (BMI) is associated with contraceptive failure of the pill, patch, or vaginal ring, investigators for the Contraceptive CHOICE Project (JW Womens Health Oct 11 2012) stratified data by BMI in 1523 participants who chose these forms of contraception. Women were followed for ≤3 years. True contraceptive failure was defined as unintended pregnancy that occurred d…