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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (14)
  • kathy-phelan-delaurodelauro
    6 years ago

    I see a lot of you take Topamax ….and just a warning, I was taking 250mg twice a day and got glaucoma! Had to have surgery and okay now, but when I went off the Topamax…weight gain! It’s all good tho! Treatment at Jefferson Headache Center in Philly! Amazing results! So…I am heavier than I want to be…5’11” and 185..size 16…but what the heck…size 12-14 with Topamax! My hubby loves me and my family does too! I am practically headache free so I will take the trade off.

  • Siotha Vest
    6 years ago

    I had a gastric bypass over 10 years ago. Now, I’m stricken with chronic migraines. Several rounds of medicine, and I’ve seen a 10lb a month weight gain over 4 months. Specialist Dr’s weren’t worried about it. Infuririated, in pain, and in general displeased with my pain management…. all I can think is I didn’t spend 10 years of my life eating healthy small portions to have a medicine ruin it, on the other hand, it’s like asking my dr to change his preference has also been guilt ridden too! How was I suposed to know Migraines were possibly genetic… ugh.

  • CathyC
    6 years ago

    I’d given away all the clothes I was *never ever* going to have in my closet again ! I’d gotten my weight under control and the migraines were responding some. Although they they figure out what the meds are trying to accomplish and they go beserk again. Darn things. Now after the last 2 preventative medications, the most recent being Depakote, weight gain is staring back at me in the mirror. Have you shared with someone that your migraine meds are the reason your gaining weight ? Why do they question it ? I don’t like that my clothes don’t fit either. So stinkin frustrating. Feed that frustration with food and gosh my jeans will fit even tighter tomorrow. I say this chuckling and not all in one. I understand your turmoil Kerrie. On the positive side the Depakote is helping in the severity of my migraines and some with the amount of them. I am so praying for the weight gain to cease and even if the dosage needs to increase that my body doesn’t increase too. Good golly ! We all deserve to feel good from the inside out : )) That’s what I’m trying to focus on….when my inside feels good then I have the energy to work on making the outside *look better*. Hugs to you !

  • Lynnekinnison
    6 years ago

    I have in no way had my migraines nearly as long as some of you and my heart dearly goes out to you. I have had Chronic migraines for almost 7 years. I am migraine free 2 or 3 days a week. 9 years ago I had gastric bypass done. I went from 224 to 138. I was glad. Now years later after all the meds I have tried that have not helped I have gone from my 138 to about 178. I am so upset about the weight gain, Ecspecially with no relief to my migraines. I pray and believe God will find a DR. will help me find something soon!!

  • Adam
    6 years ago

    Ugh! The meds seem to go to one extreme to the other. I’ve had migraines with auras since I was 5, I’m 41 now. My first preventative was Depakote and I gained 15lbs, which was extremely frustrating at the time because I was working out 3 times a week and getting fatter.I’m about 6’1″ and I was about 30lbs overweight at this point then I got switched to Topamax because the Depakote stopped preventing my auras. Then on Topamax I go from 200lbs to 150lbs. Couple of years ago I had some surgery done that ended up causing a lot of nerve pain. I got put on Neurontin and Lyrica together for almost a year and weighed 215lbs at the end of it. Less than 9 months later with literally no effort from me I was at 165lbs and now I’m at 155lbs and actually trying not to lose weight.

    I’ve had the merry go round with a few other drugs too. It does come to a certain point where you do have weigh the benefits vs the side effects. Topamax so far has been the only drug that can control the worst of my aura symptoms. I can get really bad bouts of aphasia and rare but random blackouts. It cuts the symptoms down 75-80%. If I up the dosage I could get rid of them almost completely but the side effects get too bad. It already affects my memory but that makes me dumb as a brick. I’m honestly a little scared that the effects aren’t temporary. Plus I will look unhealthy if drop any more weight.

    I do look at the bright side though. Before I was 28 or so I wasn’t taking any preventative. My auras had terrifiied me since I was a child with aphasia and auditory hallucinations. Topamax is a godsend despite how stupid I sometimes feel now. I forget a friend’s name I’ve known for 3 years! I don’t even want to think how bad the auras would now if I didn’t have it. At least you found something that does help you and you get the choice whether or not to take it. Always better to have options.

  • Kerrie Smyres moderator author
    6 years ago

    What a roller coaster! Sounds like you have a great attitude toward all the ups and downs.

    I absolutely agree that it is better to have options! After more than three dozen preventives that didn’t work, I’m sticking with the cyproheptadine despite the extra pounds.

  • japalk
    6 years ago

    I take many meds to prevent migraines but I have had chronic migraines for 27 years and have gained 60 pounds from meds and naps!! And the horrible trap of the upset stomach making you thing, Well maybe I’m hungry. So you eat and then the upset stomach comes back..so you ate something when you were not hungry..not good!! I am just now starting to lose weight thanks to Garcinia Cambogia supplements. And I have tried EVERYTHING…Hypnotism, and everything!!

  • Kerrie Smyres moderator author
    6 years ago

    I do that “maybe I’m just hungry” thing, too! I hope your meds are helpful for you. Glad to hear you’re losing some weight.

  • DebbyJ56
    6 years ago

    I have have anorexia since I was 19. I am now 56 and still struggle. No one can imagine my anxiety when a drug causes weight gain for me. I had had a ten piound allowance rule, but it neve stops there and the drug has never been effective enough to keep taking it. I have had migraines since I was five years old. Chronic daily migraines for sevn years now. Last year I lost 20 lbs for no apparent reason other than we adjusted my topamax to a lower dosage which I think activated it since I’ve been on it for so long. Now, being that light, of course I don’t want to gain any weight back even though everyone tells me I’m too thin. I have gained nine pounds back with a new med, that some say has no weight gain as a side effect. But there is some evidence that it does, so I’m watching it because it’s not helping me that much. I eat a balanced diet now and am very careful not to get into my old habits, but it is always a challenge.

  • Kerrie Smyres moderator author
    6 years ago

    Wow, anorexia and chronic migraine must be a tough combination, especially because so many migraine meds have weight gain as a side effect. Sounds like you’re taking care of yourself, though. Hang in there.

  • sspeight
    6 years ago

    I feel for you and completely understand! I have been on numerous medicines like that. It’s so hard to balance the good and the bad with these medicines. I pray that you have an understanding support system. If the drug works though and decreases your migraines, that is a huge help, even with the weight gain. When it gets really frustrating is when it doesn’t help much and it causes weight gain, yet you want to give the medicine a fair try. There are limits we all have to set. There are times that I’ve said “I’ll gain 70 lbs if it means my headaches will go away” too, but I still don’t really want the 60 additional ones when I’ve already gained 10. I don’t even like having my “fat clothes” as I call them in my closet because I don’t want to gain any weight. Alas, they stay in there just in case I may need them. Then again debilitating headaches that take my life away isn’t acceptable either. My bf says he doesn’t care about my weight, but I want to be healthy and we all feel better when we’re 10 lbs. lighter! (((HUGS)))

  • Kerrie Smyres moderator author
    6 years ago

    Thanks for your kind words. I do have a great support system and I’m the only one who cares if I gain weight — everyone else just wants me to feel better. Having written this post and gotten readers’ feedback, I’ve realized that I, too, would prefer less severe migraine attacks even if it means I’ve gained weight. I just hate that my clothes don’t fit!

  • Susan Cummings Nawazelski
    6 years ago

    I also take cyproheptadine and I have gained weight – I never attributed the weight gain to the med. I have had a hard time losing weight too. The med has helped my migraines and I would be afraid to stop it. I also take Topomax daily and Relpax when a migraine starts. Thank you for this article – it was very helpful.

  • Kerrie Smyres moderator author
    6 years ago

    I’m glad you found the article helpful. Weight gain and sleepiness are probably cyproheptadine’s main side effects. It is sometimes prescribed for people who have trouble keeping weight on or kids with ADHD who lose weight on stimulants.

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