The Emotional Turbulence of Gaining Weight on a Migraine Preventive

Weight gain is a significant side effect of many migraine medications. It is a concern I take seriously when other people ask me about medication side effects, but I wasn’t personally worried about it. I thought that any relief from debilitating migraine would be worth an extra few (or 20 or 30…) pounds to me.

Until, two months after I started taking cyproheptadine, I stepped on the scale and it screamed “YOU ARE FAT!” That’s the day I discovered that there’s a psychological magic number on the scale – a number that doesn’t seem like a big deal until you exceed it. (And, yes, I also discovered that I have Body Image Issues.)

Even though I’d watched my diet carefully, I had gained 10 pounds. Although 10 pounds isn’t much, I could only imagine a future of an ever-increasing weight while on the drug. I began to worry if I was trading a reduction in migraine severity for other, weight-related health problems. Suddenly I understood why people would stop taking a drug that helped their migraines because it made then gain weight. And I felt like a bit of a jerk for not really getting it before.

Prior to starting cyproheptadine, I thought I would do anything, even gain 70 pounds, to reduce the migraines. Now I understand there’s a cost-benefit analysis: The cost, weight gain, has to be balanced against the amount the severity and/or frequency of migraine attacks are reduced. Seventy pounds would probably be worth it if my daily migraine attacks happened once a month instead. Too bad treatment results are rarely that clear. I decided that 10 pounds to reduce the pain from a level 7 each day to a 5 or 6 is worth it, though I can’t say the weight gain didn’t nag at me.

This freak-out happened last fall. Ultimately, I gained 13 pounds on cyproheptadine before my weight stabilized. As much as I’d like to say I reached weight-related enlightenment, it bothered me every day. I was thrilled to lose four four pounds after starting Ritalin as a migraine preventive.

Shame and embarrassment keep swallowing me up when I think about posting this essay. I hate that my weight occupies so much of my thought when the weight gain is both relatively minor and for a good reason. I also have a voice in my head saying, “Get over yourself.” Even at 13 pounds above my ideal, I am a healthy weight in anyone’s perspective but my own. However, I’ve also realized there’s not much room for objectivity in the personal, psychological understanding of one’s own weight.

So I will share my emotional turmoil in the hope that it will help someone else struggling with migraine-related weight gain, whether through medication or inactivity. And I will hold my breath that I am not barraged with insults for doing so.

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