Weight gain and recurrence in idiopathic intracranial hypertension

Objective: To determine whether weight gain is associated with recurrence in idiopathic intracranial hypertension (IIH).

Methods: Medical records of adult patients with IIH seen between 1993 and 2009 at 2 university hospitals were reviewed to identify those with and without recurrence. Patients with documented height and weight at presentation and at subsequent visits were studied. The Wilcoxon rank sum test was used to compare mean body mass index (BMI) and percent weight change between the groups of patients with recurrence and without recurrence. The signed-rank test was used for comparing BMI within groups at the various time points.

Results: Fifty women with IIH were included in the analyses: 26 had IIH recurrence and 24 did not. Patients with recurrence had greater BMI at the time of recurrence compared to BMI at diagnosis (p = 0.02, signed-rank test). They also demonstrated a greater degree of weight gain between initial resolution and recurrence (BMI change +2.0 kg/m² [−1.5 to 10.8]) compared to patients without recurrence (−0.75 kg/m² [−35 to 3.6], p = 0.0009, Wilcoxon rank sum test). Patients without recurrence demonstrated stable weights (0%[95% CI −9.6 to 10.1%]), while patients with recurrence demonstrated a 6% weight gain ([−3.5 to 40.2%], p = 0.005), with an average rate of BMI gain of 1.3 kg/m²/year vs −0.96 kg/m²/year in those without recurrence.

Conclusion: Patients with IIH recurrence had significant increases in BMI compared to patients without recurrence in this cohort. Patients with resolved IIH should be advised that weight gain may be a risk factor for IIH recurrence.