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

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Abstract

Background

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.

Results

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.

Conclusions

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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Acknowledgements

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

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Authors and Affiliations

  1. Department of Medicine, University of Padua, via Giustiniani 2, 35128, Padova, Italy

    Angelo Di Vincenzo, Marco Beghetto, Roberto Vettor, Marco Rossato & Claudio Pagano

  2. Department of Medicine and Surgery, University of Parma, Parma, Italy

    Claudio Tana

  3. The Miriam Hospital/Brown Alpert Medical School, Providence, RI, USA

    Dale S. Bond

Authors
  1. Angelo Di Vincenzo
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  2. Marco Beghetto
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  3. Roberto Vettor
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  4. Claudio Tana
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  5. Marco Rossato
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  6. Dale S. Bond
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  7. Claudio Pagano
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Corresponding author

Correspondence to Claudio Pagano.

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Conflict of Interests

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

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For this type of study (meta-analysis), ethical approval is not required.

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Informed consent does not apply to this type of study.

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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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  • DOI: https://doi.org/10.1007/s11695-020-04429-z

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