Association Between Obesity and Migraine in Women

  • Jelena M. Pavlovic
  • Julio R. Vieira
  • Richard B. Lipton
  • Dale S. Bond
Migraine and Beyond (R Cowan, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Migraine and Beyond

Abstract

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.

Recent Findings

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.

Summary

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.

Keywords

Migraine Obesity Women’s health Hormones BMI Headache 

Notes

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.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Macgregor EA, Rosenberg JD, Kurth T. Sex-related differences in epidemiological and clinic-based headache studies. Headache. 2011;51(6):843–59.CrossRefPubMedGoogle Scholar
  2. 2.
    Buse DC, Loder EW, Gorman JA, et al. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache. 2013;53(8):1278–99.CrossRefPubMedGoogle Scholar
  3. 3.
    Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML, Stewart WF. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68(5):343–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Finocchi C, Strada L. Sex-related differences in migraine. Neurol Sci. 2014;35(Suppl 1):207–13.CrossRefPubMedGoogle Scholar
  5. 5.
    Maleki N, Linnman C, Brawn J, Burstein R, Becerra L, Borsook D. Her versus his migraine: multiple sex differences in brain function and structure. Brain. 2012;135(Pt 8):2546–59.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Pavlovic JM, Akcali D, Bolay H, Bernstein C, Maleki N. Sex-related influences in migraine. J Neurosci Res. 2017;95(1–2):587–93.CrossRefPubMedGoogle Scholar
  7. 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
  8. 8.
    Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Wildman RP, Sowers MR. Adiposity and the menopausal transition. Obstet Gynecol Clin N Am. 2011;38(3):441–54.CrossRefGoogle Scholar
  10. 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
  11. 11.
    Rocha VZ, Libby P. Obesity, inflammation, and atherosclerosis. Nat Rev Cardiol. 2009;6(6):399–409.CrossRefPubMedGoogle Scholar
  12. 12.
    McCarthy LH, Bigal ME, Katz M, Derby C, Lipton RB. Chronic pain and obesity in elderly people: results from the Einstein aging study. J Am Geriatr Soc. 2009;57(1):115–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Okifuji A, Hare BD. The association between chronic pain and obesity. J Pain Res. 2015;8:399–408.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    • Palmer BF, Clegg DJ. The sexual dimorphism of obesity. Mol Cell Endocrinol. 2015;402:113–9. A comprehensive review highlighting the novel ways sex hormones influence body adiposity and the metabolic syndrome CrossRefPubMedGoogle Scholar
  15. 15.
    Waraich RS, Mauvais-Jarvis F. Paracrine and intracrine contributions of androgens and estrogens to adipose tissue biology: physiopathological aspects. Horm Mol Biol Clin Investig. 2013;14(2):49–55.PubMedGoogle Scholar
  16. 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
  17. 17.
    Ford ES, Li C, Pearson WS, Zhao G, Strine TW, Mokdad AH. Body mass index and headaches: findings from a national sample of US adults. Cephalalgia. 2008;28(12):1270–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Peterlin BL, Rosso AL, Rapoport AM, Scher AI. Obesity and migraine: the effect of age, gender and adipose tissue distribution. Headache. 2010;50(1):52–62.CrossRefPubMedGoogle Scholar
  19. 19.
    Robberstad L, Dyb G, Hagen K, Stovner LJ, Holmen TL, Zwart J-A. An unfavorable lifestyle and recurrent headaches among adolescents: the HUNT study. Neurology. 2010;75(8):712–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Vo M, Ainalem A, Qiu C, Peterlin BL, Aurora SK, Williams MA. Body mass index and adult weight gain among reproductive age women with migraine. Headache. 2011;51(4):559–69.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Peterlin BL, Rosso AL, Williams MA, et al. Episodic migraine and obesity and the influence of age, race, and sex. Neurology. 2013;81(15):1314–21.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Yu S, Liu R, Yang X, et al. Body mass index and migraine: a survey of the Chinese adult population. J Headache Pain. 2012;13(7):531–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Bigal ME, Liberman JN, Lipton RB. Obesity and migraine: a population study. Neurology. 2006;66(4):545–50.CrossRefPubMedGoogle Scholar
  24. 24.
    Mattsson P. Migraine headache and obesity in women aged 40–74 years: a population-based study. Cephalalgia. 2007;27(8):877–80.CrossRefPubMedGoogle Scholar
  25. 25.
    Keith SW, Wang C, Fontaine KR, Cowan CD, Allison DB. BMI and headache among women: results from 11 epidemiologic datasets. Obesity (Silver Spring). 2008;16(2):377–83.CrossRefGoogle Scholar
  26. 26.
    Santos IS, Goulart AC, Passos VM, Molina MC, Lotufo PA, Bensenor IM. Obesity, abdominal obesity and migraine: a cross-sectional analysis of ELSA-Brasil baseline data. Cephalalgia. 2015;35(5):426–36.CrossRefPubMedGoogle Scholar
  27. 27.
    Bigal ME, Lipton RB. Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology. 2006;67(2):252–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Winter AC, Berger K, Buring JE, Kurth T. Body mass index, migraine, migraine frequency and migraine features in women. Cephalalgia. 2009;29(2):269–78.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013;93(1):359–404.CrossRefPubMedGoogle Scholar
  30. 30.
    Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States. Relation to age, income, race, and other sociodemographic factors. JAMA. 1992;267(1):64–9.CrossRefPubMedGoogle Scholar
  31. 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. 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
  33. 33.
    Chai NC, Bond DS, Moghekar A, Scher AI, Peterlin BL. Obesity and headache. Part II—potential mechanism and treatment considerations. Headache. 2014;54(3):459–71.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Bigal ME, Lipton RB, Holland PR, Goadsby PJ. Obesity, migraine, and chronic migraine: possible mechanisms of interaction. Neurology. 2007;68(21):1851–61.CrossRefPubMedGoogle Scholar
  35. 35.
    Bigal ME, Lipton RB, Stewart WF. The epidemiology and impact of migraine. Curr Neurol Neurosci Rep. 2004;4(2):98–104.CrossRefPubMedGoogle Scholar
  36. 36.
    Hattori A, Sturm R. The obesity epidemic and changes in self-report biases in BMI. Obesity (Silver Spring). 2013;21(4):856–60.CrossRefGoogle Scholar
  37. 37.
    Brown WJ, Mishra G, Kenardy J, Dobson A. Relationships between body mass index and well-being in young Australian women. Int J Obes Relat Metab Disord. 2000;24(10):1360–8.CrossRefPubMedGoogle Scholar
  38. 38.
    Winter AC, Wang L, Buring JE, Sesso HD, Kurth T. Migraine, weight gain and the risk of becoming overweight and obese: a prospective cohort study. Cephalalgia. 2012;32(13):963–71.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol. 2006;64(4):355–65.Google Scholar
  40. 40.
    Bigal ME, Lipton RB. Putative mechanisms of the relationship between obesity and migraine progression. Curr Pain Headache Rep. 2008;12(3):207–12.CrossRefPubMedGoogle Scholar
  41. 41.
    Recober A, Goadsby PJ. Calcitonin gene-related peptide: a molecular link between obesity and migraine? Drug News Perspect. 2010;23(2):112–7.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 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
  43. 43.
    Bond DS, Thomas JG, O’Leary KC, et al. Objectively measured physical activity in obese women with and without migraine. Cephalalgia. 2015;35(10):886–93.CrossRefPubMedGoogle Scholar
  44. 44.
    Cervoni C, Bond DS, Seng EK. Behavioral weight loss treatments for individuals with migraine and obesity. Curr Pain Headache Rep. 2016;20(2):13.CrossRefPubMedGoogle Scholar
  45. 45.
    Jette N, Patten S, Williams J, Becker W, Wiebe S. Comorbidity of migraine and psychiatric disorders—a national population-based study. Headache. 2008;48(4):501–16.CrossRefPubMedGoogle Scholar
  46. 46.
    Simon GE, Von Korff M, Saunders K, et al. Association between obesity and psychiatric disorders in the US adult population. Arch Gen Psychiatry. 2006;63(7):824–30.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Tietjen GE, Peterlin BL, Brandes JL, et al. Depression and anxiety: effect on the migraine-obesity relationship. Headache. 2007;47(6):866–75.CrossRefPubMedGoogle Scholar
  48. 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
  49. 49.
    Simpson ER. Sources of estrogen and their importance. J Steroid Biochem Mol Biol. 2003;86(3–5):225–30.CrossRefPubMedGoogle Scholar
  50. 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. 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
  52. 52.
    Nelson LR, Bulun SE. Estrogen production and action. J Am Acad Dermatol. 2001;45(3):S116–24.CrossRefPubMedGoogle Scholar
  53. 53.
    Chakrabarti M, Haque A, Banik NL, Nagarkatti P, Nagarkatti M, Ray SK. Estrogen receptor agonists for attenuation of neuroinflammation and neurodegeneration. Brain Res Bull. 2014;109:22–31.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Klein SL, Schiebinger L, Stefanick ML, et al. Opinion: sex inclusion in basic research drives discovery. Proc Natl Acad Sci U S A. 2015;112(17):5257–8.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Clayton JA, Collins FS. Policy: NIH to balance sex in cell and animal studies. Nature. 2014;509(7500):282–3.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Ahtiainen M, Alen M, Pöllänen E, et al. Hormone therapy is associated with better body composition and adipokine/glucose profiles: a study with monozygotic co-twin control design. Menopause. 2012;19(12):1329–35.CrossRefPubMedGoogle Scholar
  57. 57.
    Haarbo J, Marslew U, Gotfredsen A, Christiansen C. Postmenopausal hormone replacement therapy prevents central distribution of body fat after menopause. Metabolism. 1991;40(12):1323–6.CrossRefPubMedGoogle Scholar
  58. 58.
    Lavie CJ, De Schutter A, Milani RV. Healthy obese versus unhealthy lean: the obesity paradox. Nat Rev Endocrinol. 2015;11(1):55–62.CrossRefPubMedGoogle Scholar
  59. 59.
    Artham SM, Lavie CJ, Patel DA, Ventura HO. Obesity paradox in the elderly: is fatter really fitter? Aging Health. 2009;5(2):177–84.CrossRefGoogle Scholar
  60. 60.
    DePalma MJ, Ketchum JM, Saullo TR. Multivariable analyses of the relationships between age, gender, and body mass index and the source of chronic low back pain. Pain Med. 2012;13(4):498–506.CrossRefPubMedGoogle Scholar
  61. 61.
    Baker JF, Billig E, Michaud K, et al. Weight loss, the obesity paradox, and the risk of death in rheumatoid arthritis. Arthritis Rheumatol (Hoboken, NJ). 2015;67(7):1711–7.CrossRefGoogle Scholar
  62. 62.
    Martin VT, Pavlovic J, Fanning KM, Buse DC, Reed ML, Lipton RB. Perimenopause and menopause are associated with high frequency headache in women with migraine: results of the American Migraine Prevalence and Prevention Study. Headache. 2016;56(2):292–305.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Jelena M. Pavlovic
    • 1
    • 2
  • Julio R. Vieira
    • 1
    • 3
  • Richard B. Lipton
    • 1
    • 2
  • Dale S. Bond
    • 4
  1. 1.Department of NeurologyAlbert Einstein College of MedicineBronxUSA
  2. 2.Montefiore Headache CenterBronxUSA
  3. 3.Health Quest NeurologyKingstonUSA
  4. 4.Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research CenterProvidenceUSA

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