Migraine and Obesity: Moving Beyond Bmi

Abstract

37 ISSN 1479-6708 10.2217/FNL.13.65 © 2014 Future Medicine Ltd Future Neurol. (2014) 9(1), 37–40 It has been over a decade since the publication of the first study evaluating the epidemiological association between obesity and headache [1]. Since Brown et al.’s study in 2000, multiple clinical and general population studies have followed [1–3]. Methodological differences in this early research generated some controversy. Some hypothesized that the disease risk between migraine and obesity was modified by age, being stronger in those of reproductive age compared with perior post-reproductive aged individuals; others hypothesized that this association was limited to only those with high-frequency or chronic migraine (CM). Notably, those general population studies evaluating only older individuals found no association between obesity and migraine. By contrast, all general population studies evaluating reproductive-age individuals reported significant associations between migraine and obesity, with the exception of studies that included individuals with other headache types, remitted migraine and chronic daily headaches in the control group [2,4]. Most recently, Peterlin et al. evaluated the episodic migraine (EM)–obesity relationship in a cross-sectional, general population analysis of over 3800 participants [4]. Controls included participants with no headache of any type and excluded remitted migraineurs. In general, obese individuals had an 81% increased risk of EM compared with those of normal weight (odds ratio: 1.81; 95% CI: 1.27–2.57; p = 0.001). In addition, subgroup analyses demonstrated that even the odds of low-frequency EM and very low-frequency EM were increased in those with obesity (low-frequency EM: odds ratio: 1.83;95% CI: 1.26–2.65; very low-frequency EM: odds ratio: 1.89; 95% CI: 1.29–2.78). Thus, this study extended the migraine–obesity relationship to include EM of all frequencies. These findings also substantiated previous data suggesting that the risk of EM increased with increasing obesity status from normal weight to overweight to obese [4]. While the extension of the migraine– obesity association to include episodic migraineurs may appear to be only of theoretical interest, there are concrete