I'm on lamotrigine which allegedly has a low weight-gain profile. Topiramate is linked to weight-loss but the side effects...for me...were too awful to carry on so never saw this side effect or any reduction in MAV.
It is a real pain in the proverbial that a huge majority of the migraine preventatives have weight gain as a significant side effect. For some people, me being one of them, the idea of putting on excess weight would do nothing to help with the "down" feelings associated with constant MAV. I have a problem with body image related to weight and see a therapist to help cope. This has all been exarcebated by the fear that any meds. I take could make me blow up like a balloon. Combined with having an underactive thryoid, looks like the odds are stacked against me.
I run three times a week, go to the gym twice a week and eat cautioously. Even so, I stay a curvy size 14-16 and hate it.
People don't seem to realise that feeling terrified of weight gain can be a real serious problem for some, and has nothing to do with vanity or narcissism.