Obesity and migraine: A Population Study

Albert Einstein College of Medicine, New York, New York, United States
Neurology (Impact Factor: 8.29). 02/2006; 66(4):545-50. DOI: 10.1212/01.wnl.0000197218.05284.82
Source: PubMed


To assess the influence of body mass index (BMI) on the prevalence, attack frequency, and clinical features of migraine.
In a population-based telephone interview study, the authors gathered information on headache, height, and weight. The 30,215 participants were divided into five categories, based on BMI: 1, underweight (< 18.5), normal weight (18.5 to 24.9), overweight (25 to 29.9), obese (30 to 24.9), and morbidly obese (> or = 35). Migraine prevalence and modeled headache features were assessed as a function of BMI, adjusting by covariates (age, sex, marital status, income, medical treatment, depression).
Subjects were predominantly female (65% female) and in middle life (mean age 38.4). BMI group was not associated with the prevalence of migraine, but was associated with the frequency of headache attacks. In the normal weight group, 4.4% had 10 to 15 headache days per month, increasing to 5.8% of the overweight (odds ratio [OR] = 1.3), 13.6% of the obese (OR = 2.9), and 20.7% of the morbidly obese (OR = 5.7). The proportion of subjects with severe headache pain increased with BMI, doubling in the morbidly obese relative to the normally weighted (OR = 1.9). Similar significant associations were demonstrated with BMI category for disability, photophobia, and phonophobia.
Though migraine prevalence is not associated with body mass index, attack frequency, severity, and clinical features of migraine increase with body mass index group.

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Available from: Marcelo Bigal, May 13, 2014
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    • "Bigal et al. [9] "
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    ABSTRACT: The aim of this study is to determine a possible relationship between prevalence, frequency, and severity of migraine and obesity. All pertinent data from the literature have been critically examined and reviewed in order to assess the possible relationship between obesity and migraine, in particular migraine frequency and disability in children, as well as in adult population studies. Prevalence, frequency, and severity of migraine appear to increase in relation to the body mass index, although this evidence is not supported by all the studies examined. Data from literature suggest that obesity can be linked with migraine prevalence, frequency, and disability both in pediatric and adult subjects. These data have important clinical implications and suggest that clinicians should have a special interest for weight reduction of obese children suffering from migraine, prescribing and supporting intensive lifestyle modifications (dietary, physical activities, and behavioral) for the patient and the entire family.
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    • "These results were later confirmed by Bigal and Lipton18, who showed that the association between obesity and headache was stronger in transformed migraine than in chronic tension type headache (CTTH). Other studies showed the association between obesity and migraine prevalence and frequency among reproductive age subjects1920. In a large population study of over 15,500 participants, the odds of migraine were increased by approximately 39 per cent in both younger men and woman with total body obesity (woman: OR 1.39; 95% CI: 1.24-1.56; "
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    ABSTRACT: Obesity and migraine are both highly prevalent disorders in the general population, influenced by genetic and environmental risk factors. In recent studies, obesity was found to be a strong risk factor for transformed migraine and, among migraineurs, obesity was associated with frequent headaches and higher disability scores. Suggested mechanisms included: (i) obesity as a pro-inflammatory state may be associated with neurovascular inflammation in patients with migraine; (ii) elevated levels of plasma calcitonin gene-related peptide (CGRP) in obese individuals may play a role as an important post-synaptic mediator of trigeminovascular inflammation in migraine; (iii) dismodulation in the hypothalamic neuropeptide, orexin, in obese persons may be associated with increased susceptibility to neurogenic inflammation causing migraine attacks; and (iv) leptin and adiponectin can activate proinflammatory cytokine release that is involved in the pathogenesis of migraine. In addition, both conditions are associated with psychiatric co-morbidities, such as depression and anxiety, that can further increase headache frequency and disability. Therefore, the effect of obesity on migraine outcome is important. Weight and BMI should be measured and calculated in all children presenting with migraine, and weight control should be a part of the treatment.
    No preview · Article · Mar 2014 · The Indian Journal of Medical Research
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    • "Whether physical exercise and excess body mass have a similar effect on risk of localized chronic pain in the low back or neck/shoulders is unknown as per another study [17]. In the area of pain specifically, researchers have begun to examine whether increased weight may be associated with conditions like headache [18], fibromyalgia [19] and rheumatoid arthritis [20]. However the problem of overweight/ obesity and its association with pain is a question that has not been satisfactorily answered; no studies have been published to date in Indian context using BVI and BV. "
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