Does Emgality cause weight gain?

In this article:

• Emgality weight gain
• Weight loss on Emgality
• Tips for weight management
• Alternatives

In this article

• Emgality weight gain
• Weight loss on Emgality
• Tips for weight management
• Alternatives

The link between obesity and migraines is well established. People who are overweight have triple the odds of developing chronic headaches compared to those who maintain a healthy body weight, according to the American Migraine Foundation. While excess weight may increase the risk of migraines, certain migraine treatments have raised questions about whether they might also contribute to weight changes, further complicating this relationship.

If you experience migraines, chronic headaches, or cluster headaches, your provider may prescribe a medication like Emgality (galcanezumab). Emgality is a monoclonal antibody that targets calcitonin gene-related peptides (CGRPs), which researchers now know can play a key role in triggering migraine pain. FDA approved in 2018, this subcutaneous injection is available in a pre-filled syringe and is known for its effectiveness with relatively minimal side effects. Importantly, unlike some other migraine medications that have been associated with weight gain, galcanezumab has not been shown to be associated with a significant increase in body weight.

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Can Emgality cause weight gain?

A medical review found that galcanezumab is effective for both episodic and chronic migraines. The review also emphasized that side effects of Emgality are generally minimal, with most patients tolerating the medication well even after a year of use. Weight gain is not a common side effect, notes Marie Labadie-DeGennaro, DNP, an advanced practice registered nurse at the University of South Florida College of Medicine Neurology.

Labadie-DeGennaro treats many migraine patients with Emgality, and weight gain is rarely reported. “I have had it reported twice in over 5 years, and it is unclear if there is a connection,” she says.

Research supports her clinical observation. In a meta-analysis of eight separate studies, investigators found no significant changes in weight among people taking galcanezumab. While a small percentage of patients experienced shifts of at least 7% of their starting body weight, slightly more with weight gain than weight loss, these differences were not considered clinically meaningful.

Still, concern about weight gain is understandable. Most preventive migraine medications are associated with weight gain, and patients often worry about this potential side effect.

There are several possible reasons why migraine drugs in general may affect weight. Some can slow metabolism or increase appetite. Others may influence hormone levels. Certain medications also cause fatigue, which can decrease activity levels and make weight management more difficult.

If you experience weight gain while taking Emgality or another migraine treatment, seek medical advice from your provider. While the medication itself may play a role, other factors, such as lifestyle changes, other prescriptions, or underlying health conditions, can also contribute.

Does Emgality make it hard to lose weight?

“Emgality should not have any significant impact on your weight,” Labadie-DeGennaro says, including the ability to lose weight. 

That said, living with chronic headaches or migraines can make weight management more difficult for reasons unrelated to Emgality itself. For example:

• Pain can limit activity. Severe headaches may make it difficult to exercise and burn calories.
• Migraines can trigger cravings. Many people experience food cravings during or after migraine attacks, which can lead to increased caloric consumption.
• Other medications may contribute. Some migraine treatments are known to cause weight gain as a side effect.

Importantly, having migraines does not automatically mean you will gain weight. In fact, a large study of nearly 40,000 women found no significant difference in long-term weight gain over a five-year period between those with migraines and those without.

Tips for managing your weight on Emgality

Maintaining a healthy weight supports overall well-being and can also play a role in migraine management. Research suggests that weight loss may be associated with fewer headaches, making healthy lifestyle choices especially valuable for people prescribed Emgality or other migraine treatments.

“While some medications can cause weight gain, there are many strategies that can help mitigate this impact,” says Jennie Stanford, MD, an American Board of Obesity Medicine Diplomate. “Lifestyle changes are the cornerstone.”

Both Dr. Stanford and Dr. Labadie-DeGennaro emphasize six healthy habits that can help reduce migraine risk while also supporting weight control:

1. Prioritize nutrition. A balanced diet is fundamental for weight management. Beyond that, some research suggests that the Mediterranean and ketogenic diets may be especially beneficial for people with migraines.
2. Avoid added sugars, trans fats, and refined carbohydrates. These ingredients are strongly associated with weight gain and may also trigger migraines.
3. Engage in regular exercise. Physical activity not only burns calories but may also lower the frequency of migraines, according to one review.
4. Get quality sleep. Poor sleep is a well-documented migraine trigger, and chronic sleep deprivation can also contribute to weight gain.
5. Manage stress. If you experience headaches, then you probably know that stress can be a trigger. What’s more, chronic stress can lead to weight gain.
6. Drink plenty of water. Dehydration can prompt migraines in some people, while adequate water intake has been linked to weight loss.

Alternatives to Emgality

There are many treatment options for migraines, and the best alternative to Emgality often depends on your goals—whether you want to minimize side effects, avoid injections, focus on prevention, or simply treat migraines as they occur. Here are some of the main categories:

Options with mild side effects

CGRP inhibitors, the class of drugs including Emgality, are generally well-tolerated and have relatively mild side effects. Common issues include constipation, nausea, or injection site reactions. While anaphylaxis, shortness of breath, trouble breathing, and serious allergic reactions are possible, one report notes that having an autoimmune disorder could play a factor in causing those outcomes. Other CGRP inhibitors include:

• Aimovig (erenumab) and Ajovy (fremanezumab): Both are monthly self-injectable medications to prevent migraines.
• Vyepti (eptinezumab): Given by intravenous infusion once every 12 weeks in an infusion center, making it a good choice for those who prefer less frequent dosing. Like Emgality, it has not been associated with weight gain.

Oral options

For those who would rather avoid injections altogether, Qulipta (atogepant) is a daily oral pill that also belongs to the CGRP inhibitor class. Notably, it has even been linked to modest weight loss in some patients.

Medications for acute treatment (not prevention)

If your goal is to stop migraine headaches once they start rather than prevent them, triptans are a long-standing (and most likely less expensive) option. Examples include sumatriptan, Axert (almotriptan), and Amerge (naratriptan). These drugs work by activating serotonin receptors during a migraine attack. However, they are generally not effective for the prevention of migraine.

Over-the-counter options

For mild to moderate migraine pain, many people rely on over-the-counter medications such as Excedrin, Advil, Aleve, or Motrin. These can be inexpensive, convenient, safe for short-term use, and sometimes appropriate during pregnancy or breastfeeding. That said, they do not prevent migraines and are typically less effective than prescription medications for managing associated migraine symptoms like nausea.

Alternatives that may cause weight gain

Some migraine medications are linked to weight gain, which may be a concern for certain patients. These include:

• Tricyclic antidepressants
• Gabapentin and Lyrica (pregabalin), often used for neuropathic pain
• Beta blockers such as propranolol, commonly prescribed for migraine prevention but are associated with long-term weight gain

With so many options available, the right choice depends on your health history, lifestyle preferences, and how your body responds to treatment. A healthcare professional can help you weigh the benefits and risks to find the approach that works best for you.