Being overweight or obese is associated with chronic migraine.
Many studies have confirmed this. In consequence, physicians are taught to advise people with migraine [1] to «lose weight».
Is there anything more frustrating than being told that «you should lose weight?»
Like it was an easy thing to do! Even people who are otherwise healthy struggle with the famous «losing a few pounds».
Suffering from migraine may even be the cause for the weight gain to start with!
- Meal preparation can be disrupted
- Exercise is difficult to plan in a jammed schedules and might trigger attacks
- Sleep (a key factor in weight loss) is often irregular
- Migraine may lead to an emotional roller coaster that may lead to snacking and cravings
- Some migraine preventives cause weight gain (SO unfair).
Still, even if the reality is unfair, we must face it. Losing weight may improve migraine and your general health. To take action, it’s important to understand WHY weight might make your migraines worse.
Here are some scientifically demonstrated facts on how weight influences the brain:
- Posture: Being overweight is associated with general deconditioning and weakness of both major muscle groups and postural muscles. Poor posture causes increased strain on neck muscles and can be a trigger for migraine.
- Inflammation [2]: Fatty tissue is inflammatory, which may lower the migraine brain’s threshold.
- Hormones: the fatty tissue influences the hormonal levels.
- Leaky gut: being overweight makes your gut leaky, allowing some substances to enter the blood circulation and getting to your brain. Some of these substances may influence the chemistry of your brain in the wrong way or increase inflammation.
- Sleep apnea: Obesity is associated with sleep apnea [3], a condition that partially closes the airway during sleep and results in decreased oxygen in the brain. Sleep apnea is associated with headaches and increased migraines. Losing weight can reverse this and improve headaches.
Are you ready to take action now?
Many approaches can be used to lose weight. Health care professionals all agree: it has to be done progressively, with reasonable and long term changes to what you eat but also why and how you eat. (See this post [4]).
A warning about idiopathic intracranial hypertension (pseudotumor cerebri)
This condition is seen mostly in obese women, and it is associated with migraine. It is associated with chronic headaches but also the following red flags:
- Visual loss that may be transient and triggered by bending over
- Double vision
- A headache that is worse when lying down or present on awakening
- Nausea when lying down, vomiting in the morning
- Tinnitus (ringing in the ear) that may be pulsatile
- A recent weight gain
- Use of medications like retinoic acid (Accutane) and antibiotics
If you have one or more of these red flags, you should seek medical advice and get an eye exam looking for swelling of the optic disk. (See this post [5])
REFERENCES
- Bigal ME, Rapoport AM. Obesity and chronic daily headache. Curr Pain Headache Rep. 2012;16(1):101-9.
- Bigal ME, Lipton RB. What predicts the change from episodic to chronic migraine [6]? Curr Opin Neurol. 2009;22(3):269-76.
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