Obese people may be at higher risk for episodic migraine headaches, a new
Migraines involve intense pulsing or throbbing pain in one area of the head,
according to the American Academy of Neurology. Symptoms can include nausea,
vomiting and sensitivity to light and sound. Migraines affect more than 10% of
Episodic migraines -- the more common type of migraine -- occur 14 days or
fewer per month, while chronic migraines occur at least 15 days per month.
Low-frequency episodic migraines occur the least often.
In the new study of nearly 3 700 adults, those with a high body-mass index --
a measure of body fat determined using height and weight -- had much higher odds
of having episodic migraines than did those with a lower body-mass index (BMI).
This was particularly true among women, whites and people under 50. As
the BMI moved from normal weight to overweight to obese, so did the rate of
The cross-sectional study doesn't prove that obesity causes episodic
migraines. The study does, however, demonstrate that people who are obese have
an increased risk of having more of them, even low-frequency ones, said lead
author Dr B Lee Peterlin, an associate professor of neurology and the director
of headache research at Johns Hopkins University School of Medicine, in
The study is to be presented this week at the International Headache
Congress, in Boston. The data and conclusions should be viewed as preliminary
until published in a peer-reviewed journal.
Dr Gretchen Tietjen, a professor of neurology and director of the headache
treatment and research programme at the University of Toledo, in Ohio, said she
found the study interesting because previous studies had looked for connections
between obesity and chronic migraines.
"That the researchers were able to show an association between obesity and
episodic migraine lends more credence to some of the earlier studies that found
similar things," she said.
She pointed out, however, that it still isn't known which came first -- the
obesity or the migraine. There are many possible scenarios, Tietjen said. "Maybe
the person had the migraines first and then started taking medications like
amitriptyline or valproic acid," she said. "Those medications are associated
with weight gain."
The possible connection between obesity and migraines is under debate. One
theory involves inflammatory substances from fat tissue (adipose) that are
released into the system, Tietjen said.
Premenopausal women have more total adipose tissue in general than men, and
women have more superficial and less deep adipose tissue, Peterlin said. But
after menopause, adipose tissue is more similar between the two sexes.
Adipose tissue secretes different inflammatory proteins based on how much
tissue there is and where it is located. Since younger women and obese people
have more adipose tissue, this could, at least in part, explain why they get
On the other hand, Peterlin also suggested that a possible connection may be
related to the brain. "Previous imaging data in migraine patients have shown
activation of the hypothalamus, a part of the brain that controls the drive to
feed," she said. Alternatively, it could be that people who have migraines may
be more inclined to behaviours associated with weight gain, such as being less
Would losing weight mean that migraines will decrease in frequency? Although
weight loss is generally encouraged for people who are obese, that won't
necessarily result in migraine relief, both Peterlin and Tietjen cautioned.
At least two small studies have evaluated migraines on people who were obese
and underwent bariatric surgery to lose weight, Peterlin said. Although these
studies did find that some patients experienced fewer headaches, the studies
were small and more research needs to be done to see if this is consistent.
It's possible that the lifestyle changes needed for weight loss cut the
migraine frequency, rather than the weight loss itself, the experts said. People
who eliminate processed foods, high-calorie foods and alcohol -- all of which can
be migraine triggers -- could end up experiencing fewer headaches.
Unfortunately, the opposite could also be true if dieters introduce new foods
that are migraine triggers. Some people may develop migraines when they consume
certain sugar substitutes, for example. There also is limited data suggesting
that people with severe obesity who exercise may have fewer migraines, Peterlin
"Our data and previous research serve as a call to researchers in the
headache field to identify safe and appropriate treatment options for obese
[people with] episodic migraines of all classifications and not just those who
qualify for [weight-loss] surgery," she said.
Peterlin also suggested that physicians, in addition to providing lifestyle
education to their obese patients with episodic migraines, take into account the
weight-gain or weight-loss effect that migraine medications may have on their
Find out more about migraines at the American
Academy of Neurology.