Association Between Obesity and Migraine in Women
- 301 Downloads
Purpose of Review
Migraine is a common and highly disabling condition that is particularly prevalent among women and especially women of reproductive age. The tremendous rise in adiposity in the Western world has led to an epidemic of obesity in women. The particular effects of obesity on women with migraine of various ages are the focus of this review.
Conflicting findings from various studies with different approaches and populations have made challenging definitive conclusions about associations between migraine and obesity. While the association between obesity and migraine frequency has been consistently demonstrated and obesity is considered a risk factor for progression from episodic to chronic migraine, the association between obesity and migraine prevalence is still somewhat debated and appears to be dependent on gender and age, with the most consistent effects observed in women younger than 55 years of age.
Association between migraine and obesity is most commonly observed in women of reproductive age. The multimodal changes associated with age and hormonal change in women likely play a role in this relationship, as obesity does not appear to be related to migraine in women over 55 years of age. Future studies focusing on the migraine-obesity relationship in women should examine the effects of age, endogenous hormonal state, and exogenous hormones on migraine and obesity.
KeywordsMigraine Obesity Women’s health Hormones BMI Headache
Compliance with Ethical Standards
Conflict of Interest
Jelena M. Pavlovic declares grant support from the NIH (K23AG049466), and honoraria from Allergan and the American Headache Society for consultant work.
Richard B. Lipton declares research support from the NIH: 2PO1 AG003949 (program director), 5U10 NS077308 (PI), 1RO1 AG042595 (investigator), RO1 NS082432 (investigator), K23 NS09610 (mentor), and K23AG049466 (mentor). He also receives support from the Migraine Research Foundation and the National Headache Foundation. He serves on the Editorial Board of Neurology and as senior advisor to Headache. He has reviewed for the NIA and NINDS, holds stock options in eNeura Therapeutics; serves as consultant, advisory board member, or has received honoraria from American Academy of Neurology, Alder, Allergan, American Headache Society, Amgen, Autonomic Technologies, Avanir, Biohaven, Biovision, Boston Scientific, Colucid, Dr. Reddy’s, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmithKlein, Merck, Pernix, Pfizer, Supernus, Teva, Trigemina, Vector, and Vedanta. He receives royalties from Wolff’s Headache, 8th Edition, Oxford Press University, 2009, Wiley and Informa.
Julio R. Vieira and Dale S. Bond declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 7.•• Ornello R, Ripa P, Pistoia F, et al. Migraine and body mass index categories: a systematic review and meta-analysis of observational studies. J Headache Pain. 2015;16(1):27. Examined the recent literature and conducted meta-analyses on association between BMI and migraine using 11 available studies. Suggested an association between migraine and obesity likely mediated by gender and migraine frequency, with the strongest effect in obese women CrossRefPubMedPubMedCentralGoogle Scholar
- 10.McGill A-T. Causes of metabolic syndrome and obesity-related co-morbidities. Part 1: a composite unifying theory review of human-specific co-adaptations to brain energy consumption. Arch Public Heal Arch Belg Santé Publique. 2014;72(1):30.Google Scholar
- 16.Wildman RP, Tepper PG, Crawford S, et al. Do changes in sex steroid hormones precede or follow increases in body weight during the menopause transition? Results from the Study of Women’s Health Across the Nation. J Clin Endocrinol Metab. 2012;97(9):E1695–704.CrossRefPubMedPubMedCentralGoogle Scholar
- 31.Peters SAE, Huxley RR, Woodward M. Women’s reproductive health factors and body adiposity: findings from the UK Biobank. Int J Obes (Lond) [Internet]. 2015.Google Scholar
- 32.•• Chai NC, Scher AI, Moghekar A, Bond DS, Peterlin BL. Obesity and headache: part I—a systematic review of the epidemiology of obesity and headache. Headache. 2014;54(2):219–34. An excellent review with comprehensive tables examining the recent work on epidemiology of obesity and headache CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol. 2006;64(4):355–65.Google Scholar
- 42.• Bond DS, O’Leary KC, Thomas JG, Lipton RG, Papandonatos G, Roth J, et al. Can weight loss improve migraine headaches in obese women? Rationale and design of the Women’s Health and Migraine (WHAM) randomized controlled trial. Contemp Clin Trials. 2013;35:133–44. Future results of this randomized clinical trial of behavioral weight loss intervention in reproductive age women with obesity and migraine will help clarify the migraine obesity relationship and role of weight loss in improving migraine in women with obesity CrossRefPubMedPubMedCentralGoogle Scholar
- 48.Bond DS, Buse DC, Lipton RB, et al. Clinical pain catastrophizing in women with migraine and obesity. Headache. 55(7):923–33.Google Scholar
- 50.Szymczak J, Milewicz A, Thijssen JH, Blankenstein MA, Daroszewski J. Concentration of sex steroids in adipose tissue after menopause. Steroids. 63(5–6):319–21.Google Scholar
- 51.Bélanger C, Luu-The V, Dupont P, Tchernof A. Adipose tissue intracrinology: potential importance of local androgen/estrogen metabolism in the regulation of adiposity. Horm Metab Res Horm und Stoffwechselforsch Horm Métabolisme. 2015;34(11–12):737–45.Google Scholar