There is a new statement from the FSRH reassuring us that the use of oral emergency contraception (EC) in obese women is OK.
Levonorgestrel is available in Europe with the brand name 'Norlevo' and it has the warning that it is not effective in women over 80kg, and is less effective in women over 75kg. However, the FSRH advises that the evidence isn't currently strong enough to change their advice and that it would support the use of all forms of EC in obese women.
There was no statistically increased risk of pregnancy using Ella-one.
So - you can make up your own minds about how to manage this - but maybe sharing this information with women to allow them to make an informed choice would be the way forward...