The Link Between Obesity and Migraine

Obesity is a risk factor for migraine. Learn about the link between the two and how diet, exercise and medication can help.

Migraine and obesity have a connection. The risk of chronic migraine increases with weight gain—from normal weight to overweight to obese. People with migraine who are at a healthy weight have about a 3% chance of developing chronic headaches in a year. If they are overweight, they have three times that chance. With obesity, the chance of chronic migraine is five times that of a healthy weight individual with migraine. In addition, obesity increases the risk of someone with an episodic pattern of headaches developing a chronic pattern.

It’s important to understand that obesity does not cause migraine. Rather, it’s a risk factor, which means being obese makes it more likely to develop migraine. Doctors consider obesity a modifiable risk factor that can be changed (unlike age, for instance). So, if you have migraine and are obese, think of it as a goal that you, your doctors and your nutritionist can work on together as a team.

How do we define obesity and chronic migraine?

Obesity means having too much fat tissue. The most common way to measure body fat is the body mass index, referred to as BMI. BMI categorizes a person’s weight as either underweight, healthy weight, overweight or obese. BMI calculators are available online or through apps. You can calculate your BMI by using your height and body weight and applying a formula:

Weight in pounds / (height in inches)² x 703

The World Health Organization defines obesity as having a BMI of at least 30 (or at least 23 for people of Asian descent).

Chronic migraine is defined as having at least 15 headache days per month (where at least eight of those headache days have migraine features) for more than three months.

What is the link between obesity and migraine?

Since the mid-1990s, experts have come to believe that fat is a highly active substance. In fact, fat tissue secretes molecules that send signals to other body parts and systems. In people who are obese, the extra fat cells tell the body to make inflammatory proteins. This new understanding of fat cells suggests that obesity keeps the body in a mild but constant state of inflammation.

As part of this inflammatory state, the body produces pain-generating hormones and releases them from fat cells. During a migraine attack, there is a similar release of these same pain-promoting hormones. This means that obese individuals may have an extra factor that increases pain levels and headache frequency.

Can losing weight help with migraine?

Because obesity is possibly a modifiable risk factor for migraine, people with migraine who are obese may be able to reduce or eliminate this risk factor. Reaching and maintaining a healthy weight through lifestyle changes and medication choices can reduce migraine symptoms.

It’s crucial for people with migraine to stay active, whether by taking walks, practicing yoga or playing a sport. A lack of exercise increases the risk of having migraine attacks by approximately 21% in adults and 50% in adolescents. Small amounts of exercise may not result in weight loss, but regular exercise does reduce stress and anxiety and has been shown to result in fewer and less painful headaches. People who regularly exercise for about 40 to 50 minutes three days per week seem to experience the most benefits.

Can certain diets help people with migraine?

Physicians have been debating which diets can help people with migraine, partially fueled by conflicting research findings. In some cases, it’s not completely clear whether the diet or the weight loss associated with these diet changes helps decrease headache frequency. Also, everyone’s migraine is unique, and foods that reduce migraine for one person might not work for others.

While there’s no such thing as “The Migraine Diet,” some studies hint that there may be benefits from low-fat and high-protein diets, as well as diets high in specific fats. Current data suggest that a low-carb, or ketogenic, diet high in omega-3 and low in omega-6 fats can help. Some of these include:

  • Fatty fish
  • Broccoli
  • Spinach
  • Flax seeds
  • Corn

These types of foods may improve episodic migraine in overweight adults. Further research is needed to confirm these findings. Before starting any exercise or diet regimen, it is good to talk with your doctor and nutritionist.

What other measures can people with migraine take? What about medication or surgery?

Many migraine medications can affect weight and may cause either weight gain or loss. Medications used for migraine prevention that have the potential to suppress appetite include:

  • Topiramate (FDA-approved)
  • Zonisamide
  • Protriptyline

Other migraine prevention agents with mild or neutral changes to appetite include:

  • Duloxetine
  • Venlafaxine

Some medications associated with weight gain or being weight-neutral are:

  • Verapamil
  • Propanolol (FDA-approved)
  • Gabapentin

The most common medications that may be associated with weight gain are valproic acid (FDA-approved) and amitriptyline.

Remember, when you are prescribed a medication for your migraine, you should feel comfortable asking your doctor about its side effects. This helps you make the most informed decision about your care.

Currently, migraine is not a reason to pursue weight-loss surgery, also known as bariatric surgery. But if you qualify for other reasons and have the procedure, studies suggest that you may end up with fewer and less intense migraine attacks. Both gastric bypass and lap banding show promise in reducing migraine frequency. While these findings are encouraging, more studies are needed to clarify the possible benefits of surgery for people with migraine specifically.

People with migraine are encouraged to maintain a healthy weight, exercise regularly and consume a healthy diet. Addressing obesity as part of migraine treatment will result in better health and successful migraine management.

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.