A meta-analysis including 12 studies that included > 280,000 participants found that both obesity and underweight are associated with an increased risk for migraines.1
Prior research had indicated an association between higher weight and migraines and while exact mechanisms are not known, it has been postulated that overweight individuals may have increased adipose tissue secretion of pro-inflammatory cytokines, increased adipocytokines, and increased circulating sex hormones all of which may play a role in migraine development and severity. Studies have also shown patients with migraines have changes in several signaling molecules such as IL-6, which is part of the inflammatory pathway. However, there is scant literature on underweight as being a risk factor for migraine.
Dr. Gelaye and his team from the Harvard T.H. Chan School of Public Health in Boston sought to determine the association between BMI and the World Health Organization (WHO) physical status categories with migraines.
Pooled data demonstrated that obesity significantly increased risk for migraines by 27% as compared to normal weight participants (odds ratio [OR] 1.27; 95% CI: 1.16-1.37, p<0.001). However, the data also indicated in underweight individuals there was an increased risk (13%) for migraines (OR 1.13; 95% CI: 1.02, 1.24, p<0.001).
Based on this pooled data analysis, both over- and underweight body compositions have an increased risk for migraines. Additional research needs to be done to determine if a change in body composition will change the migraine status such as weight loss for individuals with obesity or weight gain in those individuals who are underweight.
Why is this Clinically Relevant?
- Clinicians should inquire about history of migraines in both underweight and overweight patients
- Excess adiposity likely contributes to occurrence and severity of migraines
- Underweight patients may also be at risk for migraines, but more research is needed to better understand the etiology here
- Achieving and maintaining a healthy weight may alleviate or at least decrease risk for migraines
- Gelaye B et al. Body composition status and the risk of migraine: a meta-analysis. Neurology. 2017;88(19):1795-1804.