Individuals with migraine who are obese may have reduced migraine frequency, lower pain intensity, shorter attack duration, and improved disability after losing weight, whether after bariatric surgery or behavioral intervention, according to the results of a meta-analysis presented at the Endocrine Society’s annual meeting, ENDO 2019, held March 23 to 26 in New Orleans, Louisiana.

For this analysis, the investigators searched electronic databases (including PubMed and Google Scholar) for studies in which the effects of weight loss (through bariatric surgery or behavioral intervention) were examined in obese individuals on the frequency and severity of migraine. A total of 10 studies (n = 473) were selected. Outcomes were frequency of headache, duration of migraine attack, pain intensity, and migraine-related disability. Moderators considered were body mass index (BMI), change in BMI, weight loss-related intervention (ie, bariatric surgery vs behavioral intervention), and population type (ie, adult vs pediatric).

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Weight loss was found to be associated with reduced headache frequency (effect size [ES], -0.65; 95% CI, -0.88 to -0.42; P <.0001), lower levels of pain (ES, -0.81; 95% CI, -1.19 to -0.44; P <.0001), improved disability (ES, -0.61; 95% CI, -0.77 to -0.45; P <.0001), and shorter duration of migraine attacks (ES, -0.35; 95% CI, -0.62 to -0.08; P =.01) in a random effect meta-analysis. The meta-regression analysis that accounted for moderators indicated that weight loss-associated improvements in migraine parameters were not correlated with baseline BMI or degree of weight loss. The nature of the weight loss intervention and the population type were not found to have any effect on migraine improvements.

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“The mechanisms underlying the link between obesity, weight loss and migraine headache are still largely unclear although it is possible that alterations in chronic inflammation, adipocytokines, obesity comorbidities [ie, obstructive sleep apnea], and overlapping behavioral and psychological risk factors may play a role,” noted the study authors.

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Di Vicenzo A, Beghetto M, Vettor R, Rossatto M, Bond D, Pagano C. Effects of bariatric and non-bariatric weight loss on migraine headache in obesity. A systematic review and meta-analysis. Presented at: ENDO 2019; March 23-26, 2019; New Orleans, LA. Abstract SAT-108.