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Association Between Obesity and Migraine in Women

  • Migraine and Beyond (R Cowan, Section Editor)
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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.

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References

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

  1. Macgregor EA, Rosenberg JD, Kurth T. Sex-related differences in epidemiological and clinic-based headache studies. Headache. 2011;51(6):843–59.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  4. Finocchi C, Strada L. Sex-related differences in migraine. Neurol Sci. 2014;35(Suppl 1):207–13.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Wildman RP, Sowers MR. Adiposity and the menopausal transition. Obstet Gynecol Clin N Am. 2011;38(3):441–54.

    Article  Google 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 

  11. Rocha VZ, Libby P. Obesity, inflammation, and atherosclerosis. Nat Rev Cardiol. 2009;6(6):399–409.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  13. Okifuji A, Hare BD. The association between chronic pain and obesity. J Pain Res. 2015;8:399–408.

    Article  PubMed  PubMed Central  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  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.

    CAS  PubMed  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bigal ME, Liberman JN, Lipton RB. Obesity and migraine: a population study. Neurology. 2006;66(4):545–50.

    Article  PubMed  Google Scholar 

  24. Mattsson P. Migraine headache and obesity in women aged 40–74 years: a population-based study. Cephalalgia. 2007;27(8):877–80.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev. 2013;93(1):359–404.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google 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.

  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

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bigal ME, Lipton RB, Holland PR, Goadsby PJ. Obesity, migraine, and chronic migraine: possible mechanisms of interaction. Neurology. 2007;68(21):1851–61.

    Article  PubMed  Google Scholar 

  35. Bigal ME, Lipton RB, Stewart WF. The epidemiology and impact of migraine. Curr Neurol Neurosci Rep. 2004;4(2):98–104.

    Article  PubMed  Google Scholar 

  36. Hattori A, Sturm R. The obesity epidemic and changes in self-report biases in BMI. Obesity (Silver Spring). 2013;21(4):856–60.

    Article  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol. 2006;64(4):355–65.

    CAS  Google Scholar 

  40. Bigal ME, Lipton RB. Putative mechanisms of the relationship between obesity and migraine progression. Curr Pain Headache Rep. 2008;12(3):207–12.

    Article  PubMed  Google Scholar 

  41. Recober A, Goadsby PJ. Calcitonin gene-related peptide: a molecular link between obesity and migraine? Drug News Perspect. 2010;23(2):112–7.

    Article  CAS  PubMed  PubMed Central  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

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Tietjen GE, Peterlin BL, Brandes JL, et al. Depression and anxiety: effect on the migraine-obesity relationship. Headache. 2007;47(6):866–75.

    Article  PubMed  Google Scholar 

  48. Bond DS, Buse DC, Lipton RB, et al. Clinical pain catastrophizing in women with migraine and obesity. Headache. 55(7):923–33.

  49. Simpson ER. Sources of estrogen and their importance. J Steroid Biochem Mol Biol. 2003;86(3–5):225–30.

    Article  CAS  PubMed  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.

  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. Nelson LR, Bulun SE. Estrogen production and action. J Am Acad Dermatol. 2001;45(3):S116–24.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Clayton JA, Collins FS. Policy: NIH to balance sex in cell and animal studies. Nature. 2014;509(7500):282–3.

    Article  PubMed  PubMed Central  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  58. Lavie CJ, De Schutter A, Milani RV. Healthy obese versus unhealthy lean: the obesity paradox. Nat Rev Endocrinol. 2015;11(1):55–62.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Van Etten 3C9B, Bronx, NY, 10461, USA

    Jelena M. Pavlovic, Julio R. Vieira & Richard B. Lipton

  2. Montefiore Headache Center, Bronx, NY, USA

    Jelena M. Pavlovic & Richard B. Lipton

  3. Health Quest Neurology, Kingston, NY, USA

    Julio R. Vieira

  4. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA

    Dale S. Bond

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  1. Jelena M. Pavlovic
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  4. Dale S. Bond
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Corresponding author

Correspondence to Jelena M. Pavlovic.

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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.

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Pavlovic, J.M., Vieira, J.R., Lipton, R.B. et al. Association Between Obesity and Migraine in Women. Curr Pain Headache Rep 21, 41 (2017). https://doi.org/10.1007/s11916-017-0634-8

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