Topiramate has been used in epilepsy and migraine for more than ten years. Recently, it has gained importance in the treatment of obesity, particularly in combination with phentermine. We report the case of a 51-year-old woman suffering from agoraphobia with panic attacks, diabetes and migraine. In addition, she simultaneously developed generalized lipomatosis leading to a weight gain of more than 20[th]kg. She was given topiramate up to 100[th]mg per day in addition to an SSRI (citalopram) and a melatoninergic drug (agomelatine). Gradually, within two years after starting topiramate, she lost 20[th]kg, with a corresponding reduction of thorax and arm circumference. Although the mechanism of weight loss remains to be clarified, topiramate may be an alternative approach in patients suffering from generalized lipomatosis.