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.
View References
Bond, D.S., PhD; Vithiananthan, S., MD; Nash, J.M.; Thomas, J.G., PhD; Wing, R.R., PhD. Improvement of migraine headaches in severely obese patients after bariatric surgery. Neurology® 2011; 76:1135–1138. • Rettner, Rachel. Weight loss surgery gets rid of migraines, too. msnbc.com. March 28, 2011. • Mozes, Alan. Weight-Loss Surgery May Cut Migraine Pain in Obese Patients. Health Day. March 28, 2011.

Comments

View Comments (13)
  • kaysus1973
    7 years ago

    This is an interesting study. However, I have a few questions. Were these patients ever evaluated/diagnosed and or treated for psuedotumor cerebri (Idiopathic Intracranial Hypertension) before their surgery? This condition causes headaches/migraines that most often is seen in obese women of childbearing ages. This study had 21 female participants…I have IIH…I have been told (and have read some of the research that says) significant amounts of weight loss can improve this condition or it can resolve itself completely. Since the majority of this study’s participants were obese women who showed marked improvement after losing significant amounts of weight I wonder if some of them may have had migraines as well as IIH?

  • Amy Lawrence
    7 years ago

    Dear Teri, I had my open Roux-N-Y May 2001 and have had a history of migraines and weight problems since puberty with black outs. When you have your surgery all your comorbidites reverse immediately, except your head issues. My biggest problems is that I had a general surgeon take care of me and my yearly lab work was maintained by my PCP and kept at the minimums for the lab. I have chronic migraines, with treatment of Topamax up to 400mg a day, Zomig & Maxalt nerve blocks every 4 weeks in between Botox treatment, Fenergan nightly and a couple of other medications and several vitamins B1,2,6,12, D, Magnesiam, iron.

    I would be interested in others who have had this done also, but I have a family hx, and long medical hx.

  • Teri Robert
    7 years ago

    Thanks for sharing your experience, Amy. As I said in my blog, this small study really doesn’t have me convinced totally convinced. I’d want to see a bigger study to be convinced that bariatric surgery had true benefit for Migraineurs. Even if it were proven to my satisfaction, nothing works for everyone, and those in the study who did have an improvement in their Migraines, still had Migraines, just not as many.

    A doctor told me to keep losing weight and my Migraines would “go away.” Uh huh. I’ve lost 110 pounds, and my Migraines are no better.

    Is the Topamax helping you at all. Most recommendations are to taper off it if it’s not helping. Have you seen a Migraine specialist. That could be a good option if you’re not making progress with your current doctor. Take a look at http://migraine.com/blog/is-it-time-for-a-new-migraine-doctor/

  • Sari Malik
    7 years ago

    There are millions of people in the United States and all over the world who are extremely plump and obese. Bariatrics is the medical field that specifically treats obesity and those suffering from it. http://www.health-tourism.com/obesity-treatment/thailand/

  • Jessica Forester
    8 years ago

    After 6 months of offering stem cell therapy in combination with the venous angioplasty liberation procedure, patients of CCSVI Clinic have reported excellent health outcomes. Ms. Kasma Gianopoulos of Athens Greece, who was diagnosed with the Relapsing/Remitting form of MS in 1997 called the combination of treatments a “cure”. “I feel I am completely cured” says Ms. Gianopoulos, “my symptoms have disappeared and I have a recovery of many functions, notably my balance and my muscle strength is all coming (back). Even after six months, I feel like there are good changes happening almost every day. Before, my biggest fear was that the changes wouldn’t (hold). I don’t even worry about having a relapse anymore. I’m looking forward to a normal life with my family. I think I would call that a miracle.”.
    Other recent MS patients who have had Autologous Stem Cell Transplantation (ASCT), or stem cell therapy have posted videos and comments on YouTube. http://www.youtube.com/watch?v=jFQr2eqm3Cg.
    Dr. Avneesh Gupte, the Neurosurgeon at Noble Hospital performing the procedure has been encouraged by results in Cerebral Palsy patients as well. “We are fortunate to be able to offer the treatment because not every hospital is able to perform these types of transplants. You must have the specialized medical equipment and specially trained doctors and nurses”. With regard to MS patients, “We are cautious, but nevertheless excited by what patients are telling us. Suffice to say that the few patients who have had the therapy through us are noticing recovery of neuro deficits beyond what the venous angioplasty only should account for”.
    Dr. Unmesh of Noble continues: “These are early days and certainly all evidence that the combination of liberation and stem cell therapies working together at this point is anecdotal. However I am not aware of other medical facilities in the world that offer the synthesis of both to MS patients on an approved basis and it is indeed a rare opportunity for MS patients to take advantage of a treatment that is quite possibly unique in the world”.
    Autologous stem cell transplantation is a procedure by which blood-forming stem cells are removed, and later injected back into the patient. All stem cells are taken from the patient themselves and cultured for later injection. In the case of a bone marrow transplant, the HSC are typically removed from the Pelvis through a large needle that can reach into the bone. The technique is referred to as a bone marrow harvest and is performed under a general anesthesia. The incidence of patients experiencing rejection is rare due to the donor and recipient being the same individual.This remains the only approved method of the SCT therapy.

  • Nancy Orlando-Bell
    8 years ago

    Dear Teri,
    Again you write another excellent article.
    Nine years ago I had a Gastric Bypass. I had the long approach where they removed some of the small and large intestine. They do not do that particular surgery type any longer. I am not an advocate for weight reduction surgery unless it is absolutely needed. But, I truly believe that you hit the nail on the head when you said that weight loss affects Migraines.
    The weight loss did help my Migraines so much! I am so glad that you wrote this article.
    Thank You, Teri!
    Tobysunny

  • Nancy Orlando-Bell
    8 years ago

    You are right again!

  • Teri Robert
    8 years ago

    Tobysunny,
    You’re most welcome! Glad the weight loss helped your Migraines. I just think we need to know a lot more about why these patients in the study were helped before we start thinking about bariatric surgery to help with Migraines. As you know, it’s major surgery, and needs to be taken very seriously. There are so many questions still.

  • Diana Lee
    8 years ago

    Thanks for breaking this down for us, Teri. I hope we’ll see some larger studies that control for some of the variables you mentioned. It seems like there’s a lot to learn.

  • Teri Robert
    8 years ago

    You’re welcome, Diana. It was an interesting study. I just wish it had been larger and that they’d asked more questions. Yes, still a lot to learn.

  • V'viee IV
    8 years ago

    migrain

  • Migraine.com
    8 years ago

    Teri Robert discusses a recent study which evaluated patients with Migraine who had bariatric surgery. The study assessed whether weight loss following surgery would be associated with improvement in Migraine.

  • Gwendolyn Pridemore
    8 years ago

    It makes sense…increase of bloodpressure due to weight would make a migraine feel more intense…weight loss of ANY type could lead to the lessening of pain…Our society is on average LARGE and losing some weight can only help in EVERY way to being a healthier individual.

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