Do you frequently experience throbbing headache, typically on one side? Does the pain disturb your routines? If yes, you might have migraines and yes, you may blame your excess body weight for causing this painful condition. Migraine has a significant impact on one’s quality of life and numerous studies show that migraine is a major comorbidity with obesity. Obesity has also been shown to be associated with increased progression and frequency of migraine attacks.
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Migraine +
Migraine is a condition that causes throbbing pain or intense pulsating sensation in the head. It typically occurs on one side of the head and may last for 2-72 hours. It is often accompanied by nausea, vomiting and increased sensitivity to light, sound or movement. Migraine is prevalent among individuals aged between 25-55 years. Globally, migraine is less prevalent in Asia when compared to USA and Europe.
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Correlation between obesity and migraine +
Though many studies have shown a strong correlation between obesity and migraine, how obesity and migraine are linked is not very clear as yet. The following are some evidence to explain this correlation:
- Obesity may cause migraines: Obesity is associated with high levels of pro-inflammatory mediators in blood which may trigger migraine.
- Migraine may predispose obesity: Chronic migraine causes an individual to live a sedentary life and also, take medications which may increase weight.
- Environmental risk factors: Factors such as sedentary lifestyle and stress can predispose both obesity and migraine.
- Genetic predisposition: Migraine and obesity may share a common genetic basis.
Common conditions associated with both migraine and obesity:
- Depression and anxiety: These are most common disorders seen in obese individuals. They may act as the risk factors for developing migraine. They may also cause higher headache frequency and disability.
- Obstructive sleep apnea (OSA): OSA is one of the common complications of obesity which leads to sleep disturbances- a common trigger for migraine attacks. They may also increase the frequency of migraine headache and promote progression of an episodic migraine to chronic migraine.
- Blood pressure and cholesterol levels: Elevated blood pressure and cholesterol levels are very common obesity comorbidities. These factors may increase the risk of migraine and its progression in the individuals who already have migraine.
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Obesity and migraine- underlying mechanisms +
Studies have suggested the following mechanisms that explain the link between obesity and migraine:
- Inflammatory mediators like Tumor necrosis factor (TNF), Interleukin (IL)-6, and mast cells are secreted by fat cells and have been found to be elevated during migraine attacks as well.
- Calcitonin gene-related peptide (CGRP) is the chemical that is released in the brain circulation during an acute attack of migraine. It is an important factor related to the progression of pain during a migraine attack. High level of CGRP have been found in obese people.
- Orexins are neurochemicals that modulate appetite and metabolism. Recently, they have been found to play a vital role in pain processing. Orexin A also inhibits neurogenically induced blood vessel dilation in the head- a known mechanism for migraine.
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Steps towards improvement +
Now we know that there is a definite relationship between obesity and migraine. Thus, management of migraine should also consider treating obesity. Moreover, evidence also suggests that reduction in body weight has a positive impact on patients with migraines. Decrease in fat consumption and an increase in physical activity, the main factors helpful in weight loss, have been found to be strongly associated with reduction in frequency and severity of migraine. Especially, a decrease in BMI was closely associated with the reduction of frequent attacks. The following favorable outcomes of weight reduction may have a positive impact on migraine.
- Increases endorphins that may decrease stress levels
- Increases serotonin levels that help in regulating sleep patterns and appetite
- Reduces levels of neurochemicals involved in depression
- Reduces hypertension and hyperlipidemia
- Reduces sleep apnea
Other dietary changes that may help to reduce the frequency of attacks in people with obesity include:
- Avoiding processed foods and high-calorie foods
- Include a low carbohydrate diet (Ketogenic diet)
- Including a diet rich in omega 3 fatty acids
- Avoiding alcohol
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Outlook +
All people with obesity may not develop migraine, but obesity may have negative impact on migraine with respect to frequency and severity. Positive steps towards weight management and making necessary lifestyle changes may become helpful in migraine management. Certain exercises and foods may act as triggers for migraine. So, it is important to consult doctor before starting any physical exercise regime and dietary modifications that may help in finding the appropriate activity and dietary recommendations for weight reduction and management of migraine attacks.
References
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974024/
2. http://www.ijpp.com/IJPP%20archives/2018_62_4/453-457.pdf
3. https://www.researchgate.net/publication/7415025_Obesity_and_migraine_A_Population_Study
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3971380/
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996319/
6. https://www.sciencedaily.com/releases/2019/03/190323145207.htm
7. https://www.ncbi.nlm.nih.gov/pubmed/19496830
8. https://pdfs.semanticscholar.org/caee/f14fb211106efccd3af7223e459049fd3987.pdf
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