Depo-Provera results in a state of profound hypo-estrogenism. Since estrogen is an insulin-sensitizer, it makes sense that weight gain might be a problem. I have long added one mg of estradiol a day to my patients using Depo-Provera. (Unlike OCP, if you miss a pill or two you don't bleed or get pregnant.) It seems like they have less problem with weight, depression, libido and spotting, and it should prevent the bone loss associated with Depo-Provera. The price is $4 a month at Target and Wal-Mart.