Nicholson Robert, Bigal Marcelo
St. Louis University School of Medicine--Community and Family Medicine, St. Louis, MO, USA.
Headache. 2008 Jan;48(1):51-7. doi: 10.1111/j.1526-4610.2007.00975.x.
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.
患有偏头痛的肥胖或超重个体可能面临更频繁发作偏头痛以及发展为慢性偏头痛的风险升高。这使得临床医生在患者超重或肥胖的情况下，必须将体重管理纳入偏头痛治疗计划的一部分。减肥和体重维持治疗应采用行为策略的组合，特别是营养教育、饮食干预和运动咨询，作为一线干预措施。减肥药物被视为二线治疗；然而，当使用减肥药物时，监测药物对头痛的影响至关重要。同样，考虑偏头痛预防的临床医生需要考虑所考虑的药物制剂是否会影响体重增加或减轻。
