There has been a lot of hype in the media lately about obesity, migraines and a possible connection. The AHS (American Headache Society) has put out a short statement on their website stating that there is no correlation at the present time. HOWEVER..a few studies published in the last two years concerning obesity and migraines have generated some talk in the Neurology community.



One study from 2005, by Dr. Marcelo Bigal, noted that while the prevalence of migraines were not related to a particular BMI (body mass index), an increase in BMI resulted in an increase in the frequency of migraines. While fat people had no more migraines than thin people, those who were gaining weight had an increase in their frequency of migraines.

Another study by Dr. Andrew Hershey at Cinncinnati Children's Hospital Medical Center demonstrated that 91% of obese children had migraines. (Read that statement again!!)

So what does this all mean to you, the migraineur? Well there might be a couple of things going on here. If you are obese you are less likely to exercise. Obese people tend to eat poorly in addition to lack of exercise and diet may also play a role. Reducing dietary triggers, and increasing aerobic exercise three times a week has been shown to reduce the frequency of migraines.

Obese migraineurs are 4 times more likely to have depression also! Up to 85% of all people in chronic pain tend to have depression or anxiety to some degree. This leads to apathy and less exercise which results in weight gain. This is also tied to migraines, as pain fibers and mood fibers are closely linked in the brain. Therefore, exercise may not only reduce weight, but also migraine frequency.

Wait! How does that happen? Seratonin! These receptor sites in the brain are involved in the migraine process. When you exercise you increase your seratonin levels and the theory is...more seratonin, less headaches. This is also the theory behind why some SSRI's (anti-depressants that boost seratonin levels) also prevent headaches. Exercise also releases endorphins which is another of your brain's self made happy drugs. Between the two, this is why you feel so good after exercising. Sort of a self rewarding system isn't it?

Obviously the key here is to exercise and lose weight. There are plenty of nutritional diets and plans available on the net now, so you really don't have an excuse. There are dozens of excellent programs available such as Weight Watchers, Jenny Craig and Nutri-system. Additionally, you must not be so resistant to medications to treat migraine and depression. Some of these medications may actually treat both! (Two for the price of one.)

In short, treatment of obesity and migraines involves many factors and the link may be tied to lifestyle. As lifestyle improves through diet and exercise, perhaps migraine profiles may also improve with less headaches.

References:

Bigal ME, Leberman JN, Lipton RB. Obesity and Migraine: A population study. Neurology 2006;66:545-550

Hershey, AJ. Obesity in Children with Migraine. Neurology Today. 2007;25