Effects of Surgical and Non-surgical Weight Loss on Migraine Headache: a Systematic Review and Meta-Analysis



The aim of this study was to perform a meta-analysis on the effect of weight loss obtained by bariatric surgery or behavioral intervention on migraine frequency and indices of severity.

Materials and Methods

A search through Pubmed/Medline, ISI-web of knowledge, and Google Scholar retrieved 10 studies (n = 473). Selected outcomes were Headache Frequency, Pain Severity, Disability, and Attack Duration while BMI, BMI change, type of intervention (bariatric vs. behavioral), and type of population (adult vs. pediatric) were used for moderators and meta-regression analysis.


Random effect meta-analysis shows that weight loss yields significant reductions in Headache Frequency (ES − 0.78, p < 0.0001), Pain Severity (ES − 1.04, p < 0.0001), Disability (ES −0.68, p < 0.0001), and Attack Duration (ES − 0.25, p = 0.017). Improvement in migraine was not correlated either to the degree of obesity at baseline or the degree of weight reduction. The effect on migraine was similar when weight reduction was obtained with bariatric surgery or behavioral intervention and was comparable in adult and pediatric populations.


Weight loss improves characteristics of migraine headache in patients who have obesity independently of the type of intervention and the amount of weight loss. The mechanisms underlying the link between obesity, weight loss, and migraine headache may include chronic inflammation, obesity comorbidities, and overlapping behavioral and psychological risk factors.

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  1. 1.

    Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766–81.

    Article  Google Scholar 

  2. 2.

    Bigal ME, Lipton RB. The epidemiology, burden, and comorbidities of migraine. Neurol Clin. 2009;27(2):321–34.

    Article  Google Scholar 

  3. 3.

    Stovner LJ, Andree CJ. Prevalence of headache in Europe: a review for the Eurolight project. Headache Pain. 2010;11(4):289–99.

    Article  Google Scholar 

  4. 4.

    Buse DC, Greisman JD, Baigi K, et al. Migraine progression: a systematic review. Headache. 2019;59(3):306–38.

    Article  Google Scholar 

  5. 5.

    Peterlin BL, Rosso AL, Rapoport AM, et al. Obesity and migraine: the effect of age, gender and adipose tissue distribution. Headache. 2010;50(1):52–62.

    Article  Google Scholar 

  6. 6.

    Bigal ME, Liberman JN, Lipton RB. Obesity and migraine: a population study. Neurology. 2006;66:545–50.

    Article  Google Scholar 

  7. 7.

    Gelaye B, Sacco S, Brown WJ, et al. Body composition status and the risk of migraine: a meta-analysis. Neurology. 2017;88(19):1795–804.

    Article  Google Scholar 

  8. 8.

    Bigal ME, Lipton RB. Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology. 2006;67(2):252–7.

    Article  Google Scholar 

  9. 9.

    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

    Article  Google Scholar 

  10. 10.

    Di Lorenzo C, Coppola G, Sirianni G, et al. Migraine improvement during short lasting ketogenesis: a proof-of-concept study. Eur J Neurol. 2015;22(1):170–7.

    Article  Google Scholar 

  11. 11.

    Jahromi SR, Abolhasani M, Ghorbani Z, et al. Bariatric surgery promising in migraine control: a controlled trial on weight loss and its effect on migraine headache. Obes Surg. 2018;28(1):87–96.

    Article  Google Scholar 

  12. 12.

    Hershey AD, Powers SW, Nelson TD, et al. Obesity in the pediatric headache population: a multicenter study. Headache. 2009;49(2):170–7.

    Article  Google Scholar 

  13. 13.

    Bond DS, Vithiananthan S, Nash JM, et al. Improvement of migraine headaches in severely obese patients after bariatric surgery. Neurology. 2011;76(13):1135–8.

    CAS  Article  Google Scholar 

  14. 14.

    Novack V, Fuchs L, Lantsberg L, et al. Changes in headache frequency in premenopausal obese women with migraine after bariatric surgery: a case series. Cephalalgia. 2011;31(13):1336–42.

    CAS  Article  Google Scholar 

  15. 15.

    Verrotti A, Agostinelli S, D'Egidio C, et al. Impact of a weight loss program on migraine in obese adolescents. Eur J Neurol. 2013;20(2):394–7.

    CAS  Article  Google Scholar 

  16. 16.

    Bunner AE, Agarwal U, Gonzales JF, et al. Nutrition intervention for migraine: a randomized crossover trial. J Headache Pain. 2014;15:69. https://doi.org/10.1186/1129-2377-15-69.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Bond DS, Thomas JG, Lipton RB, et al. Behavioural weight loss intervention for migraine: a randomized controlled trial. Obesity. 2018;26(1):81–7.

    Article  Google Scholar 

  18. 18.

    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;16:27–14. https://doi.org/10.1186/s10194-015-0510-z.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 19.

    Bond DS, Roth J, Nash JM, et al. Migraine and obesity: epidemiology, possible mechanisms and the potential role of weight loss treatment. Obes Rev. 2011;12(5):e362–71.

    CAS  Article  Google Scholar 

  20. 20.

    Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res. 2005;96(9):939–49.

    CAS  Article  Google Scholar 

  21. 21.

    Forsythe L, Wallace J, Livingstone M. Obesity and inflammation: the effects of weight loss. Nutr Res Rev. 2008;21(2):117–33.

    CAS  Article  Google Scholar 

  22. 22.

    Jakobsdottir S, van Nieuwpoort IC, van Bunderen CC, et al. Acute and short-term effects of caloric restriction on metabolic profile and brain activation in obese, postmenopausal women. Int J Obes. 2016;40(11):1671–8.

    CAS  Article  Google Scholar 

  23. 23.

    Lips MA, van Klinken JB, Pijl H, et al. Weight loss induced by very low calorie diet is associated with a more beneficial systemic inflammatory profile than by Roux-en-Y gastric bypass. Metabolism. 2016;65(11):1614–20.

    CAS  Article  Google Scholar 

  24. 24.

    Bianchi VE. Weight loss is a critical factor to reduce inflammation. Clin Nutr. 2018;28:21–35.

    Google Scholar 

  25. 25.

    Summer SS, Brehm BJ, Benoit SC, et al. Adiponectin changes in relation to the macronutrient composition of a weight-loss diet. Obesity. 2011;19(11):2198–204.

    CAS  Article  Google Scholar 

  26. 26.

    Fernández-de-Las-Peñas C, Fernández-Muñoz JJ, Palacios-Ceña M, et al. Sleep disturbances in tension-type headache and migraine. Ther Adv Neurol Disord. 2017;11:1–6.

    Google Scholar 

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This study was supported by a grant from the University of Padova (ex-60% to C.P.).

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Correspondence to Claudio Pagano.

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Roberto Vettor reports personal fees from Novo Nordisk and Johnson & Johnson outside the submitted work.

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Di Vincenzo, A., Beghetto, M., Vettor, R. et al. Effects of Surgical and Non-surgical Weight Loss on Migraine Headache: a Systematic Review and Meta-Analysis. OBES SURG 30, 2173–2185 (2020). https://doi.org/10.1007/s11695-020-04429-z

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  • Migraine
  • Obesity
  • Weight loss
  • Bariatric