WEDNESDAY, June 26 (HealthDay News) -- Obese people may be at
higher risk for episodic migraine headaches, a new study
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 percent of the population.
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
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 years
old. As the BMI moved from normal weight to overweight to obese, so
did the rate of headaches.
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
Dr. Gretchen Tietjen, a professor of neurology and director of
the headache treatment and research program at the University of
Toledo, in Ohio, said she found the study interesting because
previous studies had looked for connections between obesity and
"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
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 more headaches.
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 behaviors associated with weight gain, such as
being less active.
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 patients.
Find out more about migraines at the
American Academy of Neurology.
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