In order to understand link between migraine with obesity, it is important to understand how normal fattissue is distributed and its role in the body.
Subcutaneous fat tissue produce two hormones, leptin and adiponect in greater quantities. These two hormones have roles in feeding and inflammation.
Fat tissue location changes based on a person’s gender and age. Specifically, before menopause women deposit fat in greater quantities in the more superficial layer of body fat called subcutaneous adipose tissue. In contrast, perimenopausal and menopausal aged women deposit more fat in the deeper layer of body fat called visceral adipose tissuethan younger women. The expression of proteins and the function of cells of the fat tissue differ based on whether they reside in the superficial or deep fat layer. Visceral fat tissue produces greater quantities of interleukin-6 (IL-6) than subcutaneous fat tissue. IL-6 is a pro-inflammatory cytokine which is a small protein released by cells that has specific effects on the interaction, communication or behavior between cells. In contrast, subcutaneous fat tissue produces greater quantities of leptin and adiponectinthan visceral fat tissue. These two hormones have roles in feeding and inflammation.
Multiple studies have looked at the ties between obesity and episodic headache in general, chronic daily headache and specifically episodic migraine.
The first study to evaluate the obesity and headache association showed that those who were obese and had episodic headache had a greater risk of becoming chronic daily headache sufferers than those who were not obese and had episodic headache. Several studies evaluating episodic headache or episodic migraine and obesity then followed. Overall these studies support that either general or belly obesity in those of younger adult age increased headache. Specifically, studies have shown that the risk of migraine or severe headaches increased almost 40% in women with either general or belly obesity.
Studies support that the prevalence of those with high frequency episodic migraine, (those with migraine headache on 10-14 days of each month,) is higher in those with general obesity estimated based on self-reported BMI. Specifically while only 4.4% of those without general obesity and 5.8% of those who were only overweight had high frequency episodic migraine, 13.6% of those who were obese with a self-reported BMI between 30-to 34.9 and 20.7% of those with severe obesity, (defined as a self-reported BMI of 35 or more,) had high frequency episodic migraine.
The Link between Migraine and Obesity?
How episodic and chronic daily headache links to obesity is not known. It is likely that pathways which overlap and regulate feeding and migraine play a role. One region of the brain involved in this pathway is the hypothalamus. The hypothalamus participates in the regulation of feeding and becomes activated during acute migraine attacks.
Serotonin and orexin are hypothalamic brain nerve chemicals known to regulate food intake. They appear to have a role in migraine or chronic daily headache. Adiponectin and leptin are predominantly fat cell produced hormones which have receptors in the brain. They have a role in inflammation and also appear to play a role in migraine or chronic daily headache. Further research into the role of these and other obesity-related proteins and chemicals may help us to understand migraine and lead to new treatment strategies.
Women who eliminate processed foods, high-calorie foods and alcohol — all of which can be migraine triggers — could end up experiencing weight loss and fewer headaches.
One small study in Neurology found that severely obese migraneurs (average BMI 46) reported a marked reduction in the number and severity of their headaches at six months after undergoing weight reduction through bariatric surgery. Certainly the majority of obese individuals are not undergoing bariatric surgery. But, the key point here is that it would not be harmful to get control of your weight – with the added bonus that it may help your migraines in addition to a variety of other health benefits.