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Tuesday, September 17, 2013

Obese Individuals at Increased Risk for Episodic Migraine

What does obesity have to do with migraines? According to a new study by researchers at Johns Hopkins University in Maryland, obesity significantly heightens the risk for episodic migraine. In this Sept. 11 online Neurology study, B. Lee Peterlin, DO, and colleagues set out to evaluate the association between episodic migraine (EM) and obesity, as well as the influence of age, race, and sex on this relationship.

The analysis included 3,862 black and white adults interviewed in the National Comorbidity Survey Replication, a household survey of 9,282 English-speaking respondents, age 18 and older. Investigators used EM diagnostic criteria from the International Classification of Headache Disorders. The body mass index of participants was calculated and classified as underweight (<18.5 kg/m2), normal (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), or obese (≥30 kg/m2). The analyses were then stratified by age (less than 50 years old, more than 50 years old), race (white, black), and gender (male, female). Information on height, weight, and migraine frequency was obtained by self-reported survey responses.


Dr. Peterlin and colleagues identified 1,044 obese individuals, and 188 participants reported occasional or episodic migraine (fewer than 14 migraines every month). The adjusted odds of EM was 81% greater in obese individuals compared to those of normal weight (OR 1.81; 95% CI: 1.27–2.57; p = 0.001), “with a significant trend of increasing odds of EM with increasing obesity status from normal weight to overweight to obese (p = 0.001),” the researchers found.

After stratifying the results, Dr. Peterlin and coauthors found that odds of EM were particularly increased for obese individuals who were  younger than 50 years of age (OR 1.86; 95% CI: 1.20–2.89; p for trend = 0.008), white (OR 2.06; 95% CI: 1.41–3.01; p for trend ≤0.001), or female (OR 1.95; 95% CI: 1.38–2.76; p for trend ≤0.001). “Participants with EM were less likely to be above the median poverty index and to have diabetes, and were more likely to have depression and to be current smokers compared with controls,” according to the paper.

            Those clinicians treating EM patients “should promote healthy lifestyle choices regarding diet and exercise routines, as well as take particular care in their choices of medications prescribed to their patients with EM given that many can affect weight positively or negatively,” the Johns Hopkins researchers concluded.  More research may be necessary, they said, looking at the effect of weight-loss programs on episodic migraines in overweight or obese individuals.

            See Neurology Today’s previous coverage of obesity and migraine: