A behavioral weight loss strategy confers benefits similar to those of migraine education in reducing the frequency of migraine headaches, according to findings from a randomized trial published in Obesity (Silver Spring).
Investigators randomly assigned female adults (body mass index, 25.0 to 49.9 kg/m2) who experienced 4 to 20 migraine days per month to either 16 weeks of a behavioral weight loss program (n=54) or migraine education (n=56). Participants in the behavioral weight loss program attended 16 weekly group meetings and were asked to lose 1 to 2 lb/wk to achieve a 7% weight loss. In the migraine education control group, participants also attended 16 weekly group meetings that focused primarily on educating women on migraine, pharmacologic and nonpharmacologic treatments, and self-management strategies. Additionally, all participants kept a 4-week smartphone headache diary at baseline, at 16 to 20 weeks posttreatment, and at 32 to 36 weeks of follow-up.
Participants in the behavioral weight loss program achieved greater weight loss than those receiving migraine education (-3.8 kg [95% CI, -2.5 kg to -5.0 kg] vs +0.9 kg [95% CI, -0.4 kg to 2.2 kg]; P <.001) at posttreatment and follow-up. Despite the differences in weight loss, the investigators observed no differences between the 2 groups in the reduction in migraine days per month at posttreatment (-3.0 [95% CI, -2.0 to -4.0] vs -4.0 [95% CI, -2.9 to -5.0]; P =.185) or follow-up (-3.8 [95% CI, -2.7 to -4.8] vs -4.4 [95% CI, -3.4 to -5.5]; P =.378).
This study was aimed at evaluating women between the ages of 18 and 50 years with migraine, which may limit the ability to generalize these findings to older male participants with different headache severities and frequencies. In addition, the study was terminated at the end of the funding period, so the researchers were unable to determine the long-term effects of weight loss vs education on migraine reduction.
To explain the similar effects of the behavioral weight loss program and migraine education, the investigators suggest that both strategies may be “mediated by increased perceptions of emotional social support resulting from engagement with a group of individuals who all experience the adverse impact of migraine on daily life.”
Bond DS, Thomas JG, Lipton RB, et al. Behavioral weight loss intervention for migraine: a randomized controlled trial. Obesity (Silver Spring). 2018;26:81-87.