Migraines, Obesity, and Bariatric Surgery

Over the years, we’ve seen several studies showing a connection between obesity and Migraine. A recently published study evaluated patients with Migraine who had bariatric surgery to evaluate whether weight loss following bariatric surgery would be associated with improvement in Migraine.

Study methds:

  • This was a prospective observational study, which means it was designed to determine the relationship between a condition and a characteristic shared by some members of a group.
  • There were 24 participants (21 female, 3 male) with Migraine who were assessed before and six months following bariatric surgery.
  • At both assessments, weight was checked, and participants reported for the previous 90 days:
  • Migraine frequency,
  • average Migraine severity, and
  • Migraine-related disability based on the MIDAS (Migraine Disability Assessment) questionnaire.

Study results:

  • The mean number of Migraine days went from 11.1 before surgery to 6.7 after.
  • Fourteen participants reported reduction in Migraine days; four reported no difference; six reported an increase.
  • In general, participants who lost more weight showed a greater decrease in Migraine.
  • Reductions in severity of Migraines were also reduced.
  • The number of participants reporting moderate to severe disability went from 12 before surgery to three after.
  • “The current study demonstrated marked alleviation of migraine headaches in severely obese individuals after large weight losses via bariatric surgery. Moreover, patients who had greater weight loss were more likely to experience a 50% or greater reduction in headache frequency.” 1

Study conclusions:

“Severely obese migraineurs experience marked alleviation of headaches after significant weight reduction via bariatric surgery. Future studies are needed to determine whether more modest, behaviorally produced weight losses can effect similar migraine improvements.” 1

Summary and comments:

The results of this study are interesting, but raise several questions, not the least of which is, “What is the connection between weight and Migraine?” In an interview, Dr. Frederick J. de la Vega, a neurologist at the Scripps Memorial Hospital La Jolla in San Diego, made some very interesting and astute comments:

“It seems to be good news for these types of obese patients, of course. It’s a win-win. But this kind of surgery involves some risks. And so I don’t think people who suffer from migraines who are just a little chubby are going to go get bariatric surgery just to reduce their migraine risk… And secondly, there’s probably a lot of factors interacting here to influence on migraines related to the benefits of shedding all those pounds Blood pressure changes, other metabolic changes, mood changes resulting from people feeling better about themselves, increased exercise participation after weight loss. And whether the lost weight has a secondary effect on the hormone levels of women, and how all of that might impact on migraines. All of these factors would have to be looked at.”3

This was a small study with no control group. Had it been better designed, many of the factors Dr. de la Vega mentioned could have been investigated. Monitoring blood pressure changes, mood changes, exercise, and other factors that could impact the reduction in Migraine would have been fairly easy to include in the study.

While the results of this study are interesting, larger, better designed studies are needed to better evaluate what connection there may be between weight loss and reduction in Migraine. Certainly, at this time, there is insufficient evidence for obese Migraineurs to seriously consider bariatric surgery as an answer to problematic Migraines.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
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