Weight gain in people taking migraine medications may be a factor in increasing risk of cardiovascular disease (CVD).  Dr. Marcelo Bigal reported that people who gain 5% or more of their body weight while taking prophylactic migraine medications also had changes in clinical markers indicating a higher risk of CVD.  Obesity is a risk factor for migraines and overweight/obesity are risk factors for CVD.  In a study of 331 patients,  91% of the patients who lost weight were taking topiramate, while 87% of those taking amitriptyline gained weight.  Patients experienced no significant difference in migraine medication response between the 2 medications.  There was a minimal difference in migraine frequency between those who lost and those who gained weight.

Study participants who gained weight demonstrated a significant elevation in mean diastolic BP, glucose level, heart rate, total cholesterol and LDL levels.   Thos participants gaining weight had an increase in C-reactive protein levels of 1.8 mg/L while those who lost weight had a 1.9mg/L decrease in C-reactive protein levels.  Note: Ortho McNeil Janssen Scientific Affairs supported the study.

Dr. Andrew Hershey, director of the Headache Center at Cincinnati Children’s Hospital Medical Center, reported that children with higher body mass index who have headaches have greater improvement with weight loss.  The study reviewed reports from 913 children.  A BMI percentile of 6-85 in children is considered healthy, 85-95 at risk for obesity and above 95 percentile as obese.  In this study 20% of patients were labeled as obese, 37% s at risk.  Children were assessed at 3 and 6 months for headache frequency and disability using the Pediatric Migraine Disability Assessment questionnaire.  At the 3 and 6 month measurements, the children who were obese or at risk had greater improvement in headache frequency and disability.  The study revealed that obese children with migraines who have increased disability but reducing weight can decrease both headache frequency and disability.

Program components included nutrition education for children and parents, exercise, healthy food choices.  Children were not specifically instructed to lose weight.  The American Headache Society sponsored the study.