Screening and Behavioral Management: Obesity and Weight Management

Authors

  • Robert Nicholson PhD,

    1. From the St. Louis University School of Medicine – Community and Family Medicine, St. Louis, MO, USA (R. Nicholson); Ryan Headache Center – Mercy Health Research, St. Louis, MO, USA (R. Nicholson); The Albert Einstein College of Medicine – Neurology, Bronx, NY, USA (M. Bigal).
    Search for more papers by this author
  • Marcelo Bigal MD, PhD

    1. From the St. Louis University School of Medicine – Community and Family Medicine, St. Louis, MO, USA (R. Nicholson); Ryan Headache Center – Mercy Health Research, St. Louis, MO, USA (R. Nicholson); The Albert Einstein College of Medicine – Neurology, Bronx, NY, USA (M. Bigal).
    Search for more papers by this author

  • Conflict of Interest: None

Robert Nicholson, Community and Family Medicine, St. Louis University School of Medicine, 1402 S. Grand Blvd., Donco Bldg., 2nd Floor, St. Louis, MO, USA.

Abstract

Individuals with migraine headaches who are obese or overweight may be at elevated risk for experiencing more frequent migraines and for developing chronic migraine. This makes it imperative that clinicians consider including weight management as part of a migraine treatment plan in situations where the patient is overweight or obese. Weight loss and weight maintenance therapy should employ a combination of behavioral strategies, in particular nutritional education, dietary intervention, and exercise counseling, as a first line intervention. Weight loss medications are considered a secondary treatment; however, when weight loss medications are used, it is vital to monitor the influence of the medication on headache. Similarly, a clinician considering migraine prophylaxis needs to consider whether the pharmacologic agent being considered influences weight gain or loss.

Ancillary