29 March 2011

Weight loss surgery helps for migraines

Bariatric surgery may provide an added benefit to severely obese patients besides weight loss: it can also help alleviate migraine headaches, new research shows.


Bariatric surgery may provide an added benefit to severely obese patients besides weight loss: it can also help alleviate the excruciating pain of migraine headaches, according to new research published in the journal Neurology.

Researchers say obese patients who had suffered painful and debilitating migraines before bariatric surgery reported improvements in headache frequency, severity and disability just six months after surgery. At that point, most patients had lost an average of 30kg.

"Obesity is thought to contribute to worsening of migraine, particularly for severely obese individuals, yet no study has examined whether weight loss can actually improve migraine headaches in these patients," said lead author Dale Bond, Ph.D., a researcher with The Miriam Hospital's Weight Control and Diabetes Research Centre.

"Our study provides evidence that weight loss may be an important part of a migraine treatment plan for obese patients."

28 million suffer migraines in US

It is estimated that approximately 28 million Americans – mostly women – suffer from migraines. They are thought to be caused by abnormal brain activity, which is triggered by stress, certain foods, environmental factors, or other factors, although the exact chain of events remains unclear.

Migraine pain is usually moderate to severe, often described as pounding, throbbing pain, often felt on only one side of the head. Headaches can last from four hours to three days and usually occur one to four times per month. Migraine symptoms include nausea, vomiting and light sensitivity. There is no specific cure for migraine headaches, although certain medications can help reduce the number of attacks.

The Miriam study included 24 severely obese patients who suffered from migraines. The majority of participants (88%) were female, middle-aged and severely obese, with an average BMI of 46.6 prior to surgery.

More than half of all patients underwent laparoscopic gastric banding surgery; the other participants chose Roux-en-Y gastric bypass. At six months, the average BMI was 34.6.

The study

Using standard migraine questionnaires, researchers assessed patients both before and six months after bariatric surgery. They found that headache frequency was significantly reduced from before surgery (11.1 headache days) to six months postoperatively (6.7 days), with nearly half of patients showing at least a 50% reduction in frequency.

The odds of experiencing this level of improvement were higher in participants who experienced greater weight losses, regardless of the type of bariatric surgery.

The study also revealed substantial reductions in headache pain severity and related disability. Before surgery, half of all participants reported moderate to severe disability related to their migraines, often requiring medical treatment and intervention. However, six months after surgery, only 12.5% of participants reported this degree of disability.

Migraines improve despite obesity

"It's interesting to note that headache improvements occurred postoperatively even though 70% of participants were still considered obese six months after surgery," said Bond. "These findings suggest weight loss can help alleviate migraines, even though an individual's obesity has not been fully resolved."

Bond says future studies are needed to determine whether smaller, behavioural weight loss interventions also produce similar improvements in migraines.

In the United States, more than half of all adults are considered overweight or obese, and the numbers continue to rise. According to the Centres for Disease Control and Prevention, approximately 39% of Rhode Islanders are considered overweight and another 22% are considered obese. Obesity is closely linked with a number of serious health complications, such as heart disease, high blood pressure and diabetes. Bariatric surgery, when performed correctly, can help obese patients manage these conditions. - (EurekAlert!, March 2011)

Read more:
Morbid obesity - is surgery the only option?
Girls with migraine gain more weight as adults


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Headache expert

Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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