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High, low BMI linked to migraine risk

People who are either obese or underweight have an increased risk for migraine, according to data published in Neurology.

“Both migraine and obesity are conditions associated with substantial personal and societal burdens,” Bizu Gelaye, PhD, from the Harvard T.H. Chan School of Public Health, and colleagues wrote. “As obesity is a potentially modifiable risk factor, the relationship between migraine and obesity has been a focus of research interest for the last decade. Although several studies support that obesity is associated with an increased risk of migraine, results are inconsistent with regards to included populations, how obesity status is categorized, and other features of individual study design and conduct, and the conclusions drawn.”

Gelaye and colleagues performed a meta-analysis to examine the association between migraine and body composition status based on BMI. WHO physical status categories were used to define obesity (BMI 30 kg/m²) and being underweight (BMI 18.5 kg/m²). The researchers searched a systematic electronic database and identified 12 relevant studies including 288,981 participants.

Data adjusted for age and sex indicated that compared with individuals of normal weight, those with obesity had a 27% increased risk of migraine (OR = 1.27; 95% CI, 1.16–1.37; P < 0.001). After multivariate adjustments, this increased risk remained. Similarly, individuals with underweight were 13% more likely to have migraine than those of normal weight (OR = 1.13; 95% CI, 1.02–1.24; P < 0.001), and the risk remained after multivariate adjustments. Individuals with overweight with a BMI between 25 and 29.9 kg/m² were also at an increased risk for migraine (OR = 1.08; 95% CI, 1.04–1.12; P < 0.001); however, after multivariate adjustments, significance was lost.

“As obesity and being underweight are potentially modifiable risk factors for migraine, awareness of these risk factors is vital for both people with migraine and doctors,” B. Lee Peterlin, DO, coauthor of the study from Johns Hopkins University School of Medicine, said in a related press release. “More research is needed to determine whether efforts to help people lose or gain weight could lower their risk for migraine.”

According to Peterlin, the relationship between obesity and migraine was moderate and similar in size to the association between migraine and bipolar disorders and ischemic heart disease.

Age and sex are important covariates of the link between BMI and migraine, according to the researchers.

“This makes sense, as the risk entailed by obesity and the risk of migraine is different in women and men and in younger and older people,” Peterlin said. “Both obesity disease risk and the occurrence of migraine is more common in women and in younger people.”

“It’s not clear how body composition could affect migraine,” she added. “Adipose tissue, or fatty tissue, secretes a wide range of molecules that could play a role in developing or triggering migraine. It’s also possible that other factors such as changes in physical activity, medications, or other conditions such as depression play a role in the relationship between migraine and body composition.”

The researchers noted that migraine was self-reported in half of the studies evaluated and BMI was self-reported in more than half.

The FDA recently approved Trokendi XR and Qudexy XR for migraine prophylaxis in adolescents and adults. – by Alaina Tedesco

Disclosure: The researchers report receiving support from the NIH and the National Institute of Neurological Disorders and Stroke.