Skip to main content

Advertisement

Log in

Obesity and Chronic Daily Headache

  • Chronic Daily Headache (SJ Wang, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Obesity may be the greatest epidemic of modern times. It leads to diabetes and heart disease and shortens lifespan. Although not a risk factor for migraine, it is associated with an increased frequency and intensity of migraine. Obesity is also comorbid with chronic daily headache and is a major risk factor for chronification of episodic migraine in adults and children. Although obesity is not a factor in the effectiveness of migraine treatment, it does increase the peripheral and central events in migraine, ultimately increasing the neurologic potential for migraine. Although evidence suggests that obesity is a modifiable risk factor for migraine progression, it is unknown if weight loss is related to decrease in headache frequency. Recent surgical results suggest that this is true. We suggest all possible effective techniques aimed at weight loss be undertaken for migraineurs, especially obese migraineurs, and that carefully monitoring weight changes should be routinely done as part of their migraine care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Gelber RP, Gaziano JM, Orav EJ, et al. Measures of obesity and cardiovascular risk among men and women. J Am Coll Cardiol. 2008;52:605–15.

    Article  PubMed  Google Scholar 

  2. Tzamaloukas AH, Murata GH, Hoffman RM, et al. Classification of the degree of obesity by body mass index or by deviation from ideal weight. JPEN J Parenter Enteral Nutr. 2003;27:340–8.

    Article  PubMed  Google Scholar 

  3. •• National Center for Chronic Disease Prevention and Health Promotion. Overweight and obesity: obesity trends. Vol. 2011, 2011. This is a pivotal source of data on obesity from the Centers for Disease Control.

  4. Sturm R. Stemming the global obesity epidemic: what can we learn from data about social and economic trends? Public Health. 2008;122:739–46.

    Article  PubMed  Google Scholar 

  5. de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010;92:1257–64.

    Article  PubMed  Google Scholar 

  6. Deurenberg P, Yap M. The assessment of obesity: methods for measuring body fat and global prevalence of obesity. Baillieres Best Pract Res Clin Endocrinol Metab. 1999;13:1–11.

    Article  PubMed  CAS  Google Scholar 

  7. Gurney M, Gorstein J. The global prevalence of obesity—an initial overview of available data. World Health Stat Q. 1988;41:251–4.

    PubMed  CAS  Google Scholar 

  8. Finkelstein EA, Fiebelkorn IC, Wang G. State-level estimates of annual medical expenditures attributable to obesity. Obes Res. 2004;12:18–24.

    Article  PubMed  Google Scholar 

  9. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who’s paying? Health Aff (Millwood). 2003;Suppl Web Exclusives:W3-219-226.

  10. Leonardi M, Steiner TJ, Scher AT, Lipton RB. The global burden of migraine: measuring disability in headache disorders with WHO’s classification of functioning, disability and health (ICF). J Headache Pain. 2005;6:429–40.

    Article  PubMed  Google Scholar 

  11. Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343–9.

    Article  PubMed  CAS  Google Scholar 

  12. Rapoport AM. Analgesic rebound headache. Headache. 1988;28:662–5.

    Article  PubMed  CAS  Google Scholar 

  13. Mathew NT, Reuveni U, Perez F. Transformed or evolutive migraine. Headache. 1987;27:102–6.

    Article  PubMed  CAS  Google Scholar 

  14. Lipton RB, Bigal ME. Migraine: epidemiology, impact, and risk factors for progression. Headache. 2005;45 Suppl 1:S3–S13.

    Article  PubMed  Google Scholar 

  15. Yunus MB, Arslan S, Aldag JC. Relationship between body mass index and fibromyalgia features. Scand J Rheumatol. 2002;31:27–31.

    Article  PubMed  Google Scholar 

  16. Webb R, Brammah T, Lunt M, et al. Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine (Phila Pa 1976). 2003;28:1195–202.

    Google Scholar 

  17. McCarthy LH, Bigal ME, Katz M, et al. Chronic pain and obesity in elderly people: results from the Einstein aging study. J Am Geriatr Soc. 2009;57:115–9.

    Article  PubMed  Google Scholar 

  18. Bigal ME, Liberman JN, Lipton RB. Obesity and migraine: a population study. Neurology. 2006;66:545–50.

    Article  PubMed  Google Scholar 

  19. Winter AC, Berger K, Buring JE, Kurth T. Body mass index, migraine, migraine frequency and migraine features in women. Cephalalgia. 2009;29:269–78.

    Article  PubMed  CAS  Google Scholar 

  20. Scher AI, Stewart WF, Ricci JA, Lipton RB. Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain. 2003;106:81–9.

    Article  PubMed  CAS  Google Scholar 

  21. Bigal ME, Lipton RB, Holland PR, Goadsby PJ. Obesity, migraine, and CM: possible mechanisms of interaction. Neurology. 2007;68:1851–61.

    Article  PubMed  Google Scholar 

  22. Bigal ME, Tsang A, Loder E, et al. Body mass index and episodic headaches: a population-based study. Arch Intern Med. 2007;167:1964–70.

    Article  PubMed  Google Scholar 

  23. Himsworth H. Bradford Hill and statistics in medicine. Stat Med. 1982;1:301–3.

    Article  PubMed  CAS  Google Scholar 

  24. Shakir SA, Layton D. Causal association in pharmacovigilance and pharmacoepidemiology: thoughts on the application of the Austin Bradford-Hill criteria. Drug Saf. 2002;25:467–71.

    Article  PubMed  Google Scholar 

  25. Recober A, Goadsby PJ. Calcitonin gene-related peptide: a molecular link between obesity and migraine? Drug News Perspect. 2010;23:112–7.

    Article  PubMed  CAS  Google Scholar 

  26. • Hershey AD, Powers SW, Nelson TD, et al. Obesity in the pediatric headache population: a multicenter study. Headache. 2009;49:170–7. This was the first study to demonstrate that obesity was associated with increased headache headache frequency in the pediatric population.

    Article  PubMed  Google Scholar 

  27. Kinik ST, Alehan F, Erol I, Kanra AR. Obesity and paediatric migraine. Cephalalgia. 2010;30:105–9.

    PubMed  CAS  Google Scholar 

  28. Tietjen GE, Peterlin BL, Brandes JL, et al. Depression and anxiety: effect on the migraine-obesity relationship. Headache. 2007;47:866–75.

    Article  PubMed  Google Scholar 

  29. • Peterlin BL, Rosso AL, Rapoport AM, Scher AI. Obesity and migraine: the effect of age, gender and adipose tissue distribution. Headache. 2010;50:52–62. This is a study addressing obesity factors associated with the obesity/migraine influence.

    Article  PubMed  Google Scholar 

  30. Bigal ME, Gironda M, Tepper SJ, et al. Headache prevention outcome and body mass index. Cephalalgia. 2006;26:445–50.

    Article  PubMed  CAS  Google Scholar 

  31. Bigal ME, Lipton RB, Biondi DM, et al. Weight change and clinical markers of cardiovascular disease risk during preventive treatment of migraine. Cephalalgia. 2009;29:1188–96.

    Article  PubMed  CAS  Google Scholar 

  32. Bigal ME, Lipton RB. Putative mechanisms of the relationship between obesity and migraine progression. Curr Pain Headache Rep. 2008;12:207–12.

    Article  PubMed  Google Scholar 

  33. Weiller C, May A, Limmroth V, et al. Brain stem activation in spontaneous human migraine attacks. Nat Med. 1995;1:658–60.

    Article  PubMed  CAS  Google Scholar 

  34. Afridi S, Giffin NJ, Kaube H, et al. A PET study in spontaneous migraine. Arch Neurol. 2005;62:1270–5.

    Article  PubMed  Google Scholar 

  35. Matharu MS, Bartsch T, Ward N, et al. Central neuromodulation in chronic migraine patients with suboccipital stimulators: a PET study. Brain. 2004;127:220–30.

    Article  PubMed  Google Scholar 

  36. Afridi S, Matharu MS, Lee L, et al. A PET study exploring the laterality of brainstem activation in migraine using glyceryl trinitrate. Brain. 2005;128:932–9.

    Article  PubMed  CAS  Google Scholar 

  37. Bahra A, Matharu MS, Buchel C, et al. Brainstem activation specific to migraine headache. Lancet. 2001;357:1016–7.

    Article  PubMed  CAS  Google Scholar 

  38. Raskin NH, Hosobuchi Y, Lamb S. Headache may arise from perturbation of brain. Headache. 1987;27:416–20.

    Article  PubMed  CAS  Google Scholar 

  39. Veloso F, Kumar K, Toth C. Headache secondary to deep brain implantation. Headache. 1998;38:507–15.

    Article  PubMed  CAS  Google Scholar 

  40. Haas DC, Kent PF, Friedman DI. Headache caused by a single lesion of multiple sclerosis in the periaqueductal gray area. Headache. 1993;33:452–5.

    Article  PubMed  CAS  Google Scholar 

  41. Goadsby PJ. Neurovascular headache and a midbrain vascular malformation- evidence for a role of the brainstem in chronic migraine. Cephalalgia. 2002;22:107–11.

    Article  PubMed  CAS  Google Scholar 

  42. Afridi S, Goadsby PJ. New onset migraine with a brainstem cavernous angioma. J Neurol Neurosurg Psychiatry. 2003;74:680–2.

    Article  PubMed  CAS  Google Scholar 

  43. Obermann M, Gizewski ER, Limmroth V, et al. Symptomatic migraine and pontine vascular malformation: evidence for a key role of the brainstem in the pathophysiology of chronic migraine. Cephalalgia. 2006;26:763–6.

    Article  PubMed  CAS  Google Scholar 

  44. Goadsby PJ, Edvinsson L, Ekman R. Release of vasoactive peptides in the extracerebral circulation of man and the cat during activation of the trigeminovascular system. Ann Neurol. 1988;23:193–6.

    Article  PubMed  CAS  Google Scholar 

  45. Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann Neurol. 1990;28:183–7.

    Article  PubMed  CAS  Google Scholar 

  46. Goadsby PJ. Calcitonin gene-related peptide antagonists as treatments of migraine and other primary headaches. Drugs. 2005;65:2557–67.

    Article  PubMed  CAS  Google Scholar 

  47. Flier JS. The adipocyte: storage depot or node on the energy information superhighway? Cell. 1995;80:15–8.

    Article  PubMed  CAS  Google Scholar 

  48. Badman MK, Flier JS. The adipocyte as an active participant in energy balance and metabolism. Gastroenterology. 2007;132:2103–15.

    Article  PubMed  CAS  Google Scholar 

  49. Mohamed-Ali V, Goodrick S, Rawesh A, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab. 1997;82:4196–200.

    Article  PubMed  CAS  Google Scholar 

  50. Mohamed-Ali V, Flower L, Sethi J, et al. beta-Adrenergic regulation of IL-6 release from adipose tissue: in vivo and in vitro studies. J Clin Endocrinol Metab. 2001;86:5864–9.

    Article  PubMed  CAS  Google Scholar 

  51. Curat CA, Wegner V, Sengenes C, et al. Macrophages in human visceral adipose tissue: increased accumulation in obesity and a source of resistin and visfatin. Diabetologia. 2006;49:744–7.

    Article  PubMed  CAS  Google Scholar 

  52. Gram DX, Hansen AJ, Wilken M, et al. Plasma calcitonin gene-related peptide is increased prior to obesity, and sensory nerve desensitization by capsaicin improves oral glucose tolerance in obese Zucker rats. Eur J Endocrinol. 2005;153:963–9.

    Article  PubMed  CAS  Google Scholar 

  53. Altink ME, Slaats-Willemse DI, Rommelse NN, et al. Effects of maternal and paternal smoking on attentional control in children with and without ADHD. Eur Child Adolesc Psychiatry. 2009;18:465–75.

    Article  PubMed  Google Scholar 

  54. Peterlin BL, Bigal ME, Tepper SJ, et al. Migraine and adiponectin: is there a connection? Cephalalgia. 2007;27:435–46.

    Article  PubMed  CAS  Google Scholar 

  55. Peterlin BL, Alexander G, Tabby D, Reichenberger E. Oligomerization state-dependent elevations of adiponectin in chronic daily headache. Neurology. 2008;70:1905–11.

    Article  PubMed  CAS  Google Scholar 

  56. Peterlin BL. The role of the adipocytokines adiponectin and leptin in migraine. J Am Osteopath Assoc. 2009;109:314–7.

    PubMed  Google Scholar 

  57. Kondo M, Shibata R, Miura R, et al. Caloric restriction stimulates revascularization in response to ischemia via adiponectin-mediated activation of endothelial nitric-oxide synthase. J Biol Chem. 2009;284:1718–24.

    Article  PubMed  CAS  Google Scholar 

  58. Marcus JN, Aschkenasi CJ, Lee CE, et al. Differential expression of orexin receptors 1 and 2 in the rat brain. J Comp Neurol. 2001;435:6–25.

    Article  PubMed  CAS  Google Scholar 

  59. Estabrooke IV, McCarthy MT, Ko E, et al. Fos expression in orexin neurons varies with behavioral state. J Neurosci. 2001;21:1656–62.

    PubMed  CAS  Google Scholar 

  60. Chemelli RM, Willie JT, Sinton CM, et al. Narcolepsy in orexin knockout mice: molecular genetics of sleep regulation. Cell. 1999;98:437–51.

    Article  PubMed  CAS  Google Scholar 

  61. Bingham S, Davey PT, Babbs AJ, et al. Orexin-A, an hypothalamic peptide with analgesic properties. Pain. 2001;92:81–90.

    Article  PubMed  CAS  Google Scholar 

  62. Cheng JK, Chou RC, Hwang LL, Chiou LC. Antiallodynic effects of intrathecal orexins in a rat model of postoperative pain. J Pharmacol Exp Ther. 2003;307:1065–71.

    Article  PubMed  CAS  Google Scholar 

  63. Kajiyama S, Kawamoto M, Shiraishi S, et al. Spinal orexin-1 receptors mediate anti-hyperalgesic effects of intrathecally-administered orexins in diabetic neuropathic pain model rats. Brain Res. 2005;1044:76–86.

    Article  PubMed  CAS  Google Scholar 

  64. Yamamoto T, Saito O, Shono K, et al. Anti-mechanical allodynic effect of intrathecal and intracerebroventricular injection of orexin-A in the rat neuropathic pain model. Neurosci Lett. 2003;347:183–6.

    Article  PubMed  CAS  Google Scholar 

  65. Baranowska B, Wolinska-Witort E, Martynska L, et al. Plasma orexin A, orexin B, leptin, neuropeptide Y (NPY) and insulin in obese women. Neuro Endocrinol Lett. 2005;26:293–6.

    PubMed  CAS  Google Scholar 

  66. Smart D. Orexins: a new family of neuropeptides. Br J Anaesth. 1999;83:695–7.

    PubMed  CAS  Google Scholar 

  67. Overeem S, van Vliet JA, Lammers GJ, et al. The hypothalamus in episodic brain disorders. Lancet Neurol. 2002;1:437–44.

    Article  PubMed  Google Scholar 

  68. Holland PR, Akerman S, Goadsby PJ. Orexin 1 receptor activation attenuates neurogenic dural vasodilation in an animal model of trigeminovascular nociception. J Pharmacol Exp Ther. 2005;315:1380–5.

    Article  PubMed  CAS  Google Scholar 

  69. Bigal ME, Lipton RB. Modifiable risk factors for migraine progression. Headache. 2006;46:1334–43.

    Article  PubMed  Google Scholar 

  70. Sidhaye A, Cheskin LJ. Pharmacologic treatment of obesity. Adv Psychosom Med. 2006;27:42–52.

    Article  PubMed  Google Scholar 

  71. • Young WB. Preventive treatment of migraine: effect on weight. Curr Pain Headache Rep. 2008;12:201–6. This is an interesting review of the effects of preventive medication on weight.

    Article  PubMed  Google Scholar 

  72. Peterlin BL, Calhoun AH, Siegel S, Mathew NT. Rational combination therapy in refractory migraine. Headache. 2008;48:805–19.

    Article  PubMed  Google Scholar 

  73. Novack V, Fuchs L, Lantsberg L, et al. Changes in headache frequency in premenopausal obese women with migraine after bariatric surgery: a case series. Cephalalgia. Published online 23 June 2011.

  74. Lee PB. Bariatric surgery in obese migraineurs: mounting evidence but important questions remain. Cephalalgia. 2011;31:1333–5.

    Article  Google Scholar 

  75. Bigal ME, Lipton RB. Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology. 2006;67:252–7.

    Article  PubMed  Google Scholar 

Download references

Disclosures

Dr. Marcelo E. Bigal is an employee of Merck & Co. and holds stock options in the company. Dr. Alan M. Rapoport has served as a consultant for MAP Pharmaceuticals, NuPathe, Pfizer, Zogenix, Nautilus Neurosciences, and Autonomic Technologies, and has served on speakers’ bureaus for Merck & Co., Nautilus Neurosciences, and Allergan, receiving travel expense compensation from all of these companies.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alan M. Rapoport.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bigal, M.E., Rapoport, A.M. Obesity and Chronic Daily Headache. Curr Pain Headache Rep 16, 101–109 (2012). https://doi.org/10.1007/s11916-011-0232-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-011-0232-0

Keywords

Navigation