A startling 42.4% of American adults are obese, defined as having a BMI of 30 or greater. Being overweight or obese can have serious health implications, including higher risk of high blood pressure, type 2 diabetes, heart disease, stroke, and more. Studies also show that being overweight or obese is associated with higher prevalence of pain disorders, including migraines. Although studies haven’t yet made the specific connection between what factors related to obesity lead to migraines, the consensus amongst researchers is that individuals that are overweight or obese are at higher risk of developing migraines, oftentimes leading to people experiencing them chronically.
Several large scale studies have focused on the connection between weight and migraine prevalence by sorting people based on their height and weight, calculating their BMI. Participants were categorized into groups of underweight, normal weight, overweight, obese, and morbidly obese. Results indicated that chronic daily headaches are more prevalent in obese and morbidly obese people than those with normal body weight. The majority of respondents were female (64 percent) and had an average age of 43.
Researchers pointed out several factors that impacted their categorization, and consequently the results of the study:
- Obesity defined by BMI cannot distinguish between fat and muscle mass or between abdominal and peripheral fat distribution Abdominal visceral fat is metabolically different from other body fat, and appears to be an independent risk factor for medical complications. Abdominal obesity is a focus in migraine studies, as this adipose tissue (a special connective tissue made up mainly of adipocytes that synthesize and store fat), produces multiple substances potentially involved in causing migraine, such as systemic inflammation. Because of the limitation of BMI to differentiate between these factors, waist circumference has been suggested as a better measure of abdominal fat than BMI, and for the purpose of measuring health risks.
- Fat distribution and migraine prevalence vary with sex and age, and it is possible that the relationship between the two also changes with these factors. Study results found that increased migraine prevalence occurred in obese women of reproductive age, but one 2017 study found the connection didn’t seem to apply to obese women over the age of 55 years. Other population-based studies of older people typically found no association between obesity and migraine.
- Tension-type headache (TTH) has typically not been examined by these population-based studies. You can read more about the different types of headaches, here.
What causes the migraines?
In a 2017 meta-analysis, (meaning a number of studies on the topic were examined), researchers looked at 12 studies on the link between BMI and migraine, involving a total of 288,981 people. They found that those who were obese were 27% more likely to have migraine than those of normal weight. They also found that those who were underweight had a 13% higher risk of migraine than people of normal weight, though there were fewer studies on this particular association.
While the exact ties between obesity, migraines, and weight loss are not completely understood, authors of several studies state that factors like chronic inflammation, adipocytokines (which affect appetite and satiety, glucose and lipid metabolism, blood pressure regulation, inflammation and immune functions), obesity comorbidities, and other factors likely play a role. Sleep disruption associated with obesity could also lead to people experiencing migraines, some researchers said.
How to decrease migraine prevalence related to weight
Headaches can seriously impact how your day plays out. Even minor headaches can be distracting, causing people to change plans, sometimes resulting in nausea, impact to appetite, and affects work or school performance. Obese people reported missing more days of work (four or more a year) due to headaches, compared to individuals in the other weight categories. In addition to the impact on the daily routine, “The findings suggest that people with obesity were more likely to report frequent, more painful, and more debilitating headaches than other groups we encountered,” said Marcelo E. Bigal, MD, PhD, of the Albert Einstein College of Medicine and lead author of one study.
So what can be done? Research has found that weight loss in adults and children with obesity greatly decreases migraine headache prevalence and the migraine symptoms themselves- pain severity and headache duration decreased. “If you suffer from migraine headaches and are obese, losing weight will ameliorate the quality of your family and social life as well as your work and school productivity. Your overall quality of life will greatly improve,” said lead study author Claudio Pagano, M.D., Ph.D., an associate professor of internal medicine at the University of Padova in Padova, Italy.
Interestingly, the effect on migraine was similar when weight reduction was achieved through bariatric surgery or behavioral intervention.
Kids showed similar symptoms
Multiple studies have shown that the more obese you are, the higher your risk of having migraine; this increased risk for migraines is also present in obese children. Overweight children and teens are more likely than thinner adolescents to have headaches, researchers reported at the 48th Annual Scientific Meeting of the American Headache Society in Los Angeles.
Andrew D. Hershey, MD, PHD, director of the Headache Center, and a pediatric neurologist at Cincinnati Children’s Hospital Medical Center was part of one pediatric study presented at the meeting. He shared “Kids who are obese are also more likely to have increased disability from their headache.” They miss more school and other activities, mirroring the impact that headaches can have on adults. Hershey and his colleagues evaluated 466 children, aged 3 to 18, who visited one of seven pediatric headache centers. Most of them (91.1%) were diagnosed with migraine headaches, the other 8.9% had other types of headaches.
The researchers, which also used BMI to categorize children by their weight, found that the young headache sufferers were 36% more likely to be overweight than children in the general population.
“The question of whether obesity directly leads to headaches is not solved,” Hershey said. The association is complicated, but he suspects children with frequent headaches may be exercising less, and therefore gaining weight. Hershey emphasized, however, that he did not find a cause-and-effect relationship. “Obesity doesn’t cause you to have a migraine,” he said.
These studies make one thing clear- being overweight or obese only increases your chance of experiencing migraine headaches, on top of all the other health risks associated with carrying extra weight. Speak to your provider about how to build a balanced lifestyle that includes maintaining a healthy weight to prevent experiencing migraine headaches and improve overall health.