Episodic migraines associated with obesity, especially in younger women

Episodic migraines (≤14 headache days/month) are associated with obesity, with the strongest relationships among those younger than 50 years, of white race and of female sex, a study found.

Researchers studied 3,862 adult participants of both black and white race interviewed in the National Comorbidity Survey Replication. Results were published online Sept. 11 by Neurology.

In the study, 188 participants had episodic migraine. The unadjusted prevalence estimate of obesity was 32.2% among those with episodic migraine and 26% among controls (P=0.18). After adjustment for age, sex, race, poverty, smoking, diabetes and depression, the adjusted odds of episodic migraine were greater in individuals who were obese compared with those of normal weight (odds ratio [OR], 1.81; 95% CI, 1.27 to 2.57; P=0.001).

There were no significant increases in the mean headache frequency in participants with episodic migraine based on obesity status. Compared with normal-weight people, the odds of episodic migraine were greater in obese people who were younger than 50 (OR, 1.86; 95% CI, 1.20 to 2.89; P for trend ≤0.008), white (OR, 2.06; 95% CI, 1.41 to 3.01; P for trend ≤0.001), or female (OR, 1.95; 95% CI, 1.38 to 2.76; P for trend ≤0.001).

The authors noted that:

• the odds of lower-frequency episodic migraine increased by 83% to 89% in obese people compared to those with normal weight;
• the odds of migraine were not increased in obese individuals 50 years and older;
• although the odds of episodic migraine increased with obesity in both black and white participants, the odds of episodic migraine were twofold higher when analyses were limited to only white obese participants; and
• the odds of episodic migraine were not increased in obese men in the study, although it may be that the relationship is merely stronger in women than men.

The researchers wrote, “These findings suggest that clinicians treating patients with EM [episodic migraine] should promote healthy lifestyle choices regarding diet and exercise routines, as well as take particular care in their choices of medications prescribed to their patients with EM given that many can affect weight positively or negatively.”