Weight loss is a mainstay of therapy for obese patients with idiopathic intracranial hypertension (IIH). Barbara Newborg,1 an internist, performed the first study of a low-calorie rice-based diet among 9 patients in 1974. This diet generated rapid weight loss and resolution of symptoms; however, visual parameters were not assessed. Subsequent case series from neuro-ophthalmologic practices indicated that a reduction of approximately 6% of body weight with or without concomitant medical therapy was associated with a reduction in papilledema and improvements in visual parameters.2,3 The Idiopathic Intracranial Hypertension Treatment Trial (IIHTT), the first randomized placebo-controlled clinical trial for this condition, enrolled newly diagnosed patients with mild visual field loss to assess the effect of acetazolamide therapy compared with placebo.4 All participants had access to weight loss coaches from the New York Nutrition and Obesity Research Center via telephone. The acetazolamide group experienced statistically significant improvements in visual field assessments, papilledema grade, and quality-of-life measures compared with the placebo group. Moreover, they lost more weight.