Obesity increases chances migraine headaches will become chronic

Migraines affect 30 million Americans. While most have episodic migraines, 2.5% of migraine sufferers (migraineurs) progress to chronic migraine each year. According to the National Headache Foundation, chronic migraine is present when persons “experience headache more than half the time.”

Chronic migraine markedly impacts individual health and society. Researchers at the Department of Neurology, University of Essen, in Essen, Germany, describe the impact:

Chronic migraine (CM) and episodic migraine (EM) are part of the spectrum of migraine disorders, but they are distinct clinical entities. Population-based studies have shown that those with CM demonstrate higher individual and societal burden because they are significantly more disabled than those with EM and have greater impaired quality of life both inside and outside the home.

Thus, being able to prevent or reduce the transformation of episodic to chronic migraine would provide pronounced health benefits. Among the researchers investigating the underlying factors that might trigger this transformation is Johns Hopkins neurologist, Dr. Lee Peterlin. In an article published in the Spring 2012 print issue of NeuroLogic, Dr. Peterlin, herself a migraineur, describes the observation that stimulated her interest in studying the relationship between migraines and obesity:

One thing physicians have long known, however, is that migraine sufferers – or migraineurs – are significantly more likely to be women of reproductive age. After puberty, body fat makes a significant jump in this population.

Dr. Peterlin began her work by reviewing previous migraine research. From this she learned that persons with episodic migraines were 5 times more likely to develop chronic migraines if they were obese. She also found evidence that a sedentary lifestyle increased the chances of developing chronic migraine.

In 2008, Dr. Peterlin discovered that adiponectin (a protein hormone secreted by adipose tissue) was elevated in persons with migraine in comparison to those without migraine. Currently, she is studying pro-inflammatory substances called adipokines secreted by fatty tissue.

To date, Dr. Peterlin's research has identified two suspects, protein hormones and pro-inflammatory substances, secreted by adipose tissue that may trigger the conversion of episodic to chronic migraine.

Bottom line: Weight reduction in obese persons will decrease the likelihood that migraine becomes chronic. Overweight or obese persons suffering from migraine should discuss a non-inflammatory diet (such as the ancestral diet) with their doctor. Exercise also appears effective in reducing the chances of developing chronic migraine. The mechanisms leading to the development of chronic migraine are under study.

Note: Another headache condition associated with obesity is idiopathic intracranial hypertension (IIH), also know as pseudotumor cerebri (not a true tumor).  In this condition, debilitating headaches (and sometimes loss of vision) are due to increased brain pressure. IIH most often occurs in obese women of childbearing age and is treated differently from migraine.

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