How effective is weight loss in improving visual function in IIH and how much weight loss/what strategies (i.e., formal exercise program, weight loss medications) do you recommend/counsel patients on?

Weight loss is a cornerstone of IIH management because it lowers intracranial pressure (ICP), which in turn improves papilledema and visual function. It works but should not be used alone for cases with moderate or progressive visual loss. In the IIH Weight Trial,[1] the magnitude of weight loss correlated with ICP reduction, and disease remission was associated with substantial weight loss (approximately 24%). A 2023 Neurology systematic review supports bariatric surgery as the most robust option for sustained weight loss in women with IIH and BMI ≥35 kg/m2.[2] The same review found multicomponent lifestyle intervention had the strongest evidence for modest weight loss when BMI was <35 kg/m2. More modest weight loss can still be very clini...