Behavioral Weight Loss Intervention for Migraine: A Randomized Controlled Trial

Objective The objective of this study was to test whether behavioral weight loss (BWL) intervention decreases headaches in women with comorbid migraine and overweight or obesity. Methods This randomized, single‐blind trial allocated women 18 to 50 years old with 4 to 20 migraine days per month and a BMI = 25.0‐49.9 kg/m2 to 16 weeks of BWL (n = 54), which targeted exercise and eating behaviors for weight loss, or to migraine education control (ME, n = 56), which delivered didactic instruction on migraine and treatments. Participants completed a 4‐week smartphone headache diary at baseline, posttreatment (16‐20 wk), and follow‐up (32‐36 wk). The primary outcome was posttreatment change in migraine days per month, analyzed via linear mixed effects models. Results Of 110 participants randomly assigned, 85 (78%) and 80 (73%) completed posttreatment and follow‐up. Although the BWL group achieved greater weight loss (mean [95% CI] in kilograms) than the ME group at posttreatment (−3.8 [−2.5 to −5.0] vs. + 0.9 [−0.4 to 2.2], P