Kate H. Gamble, Senior Editor
Bariatric surgery can lead to total or partial alleviation of migraines in nearly 90% of morbidly obese patients diagnosed with migraine headaches, according to a study presented at the 28th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).
A follow-up of 3 years after gastric bypass surgery showed that more than 70% of patients never had another migraine and more than 18% had partial resolution, with migraine attacks dropping from 5 to 2 per month. These patients also experienced less painful migraines and took fewer medications. Eleven percent of patients had no change in migraine status.
“The incidence and severity of migraines was greatly reduced after bariatric surgery and weight loss, suggesting there are a number of people who are suffering from migraines who otherwise might not but for their excessive weight,” said Isaac Samuel, MD, of the University of Iowa Obesity Surgery Program, in a statement
Researchers reviewed the medical records of 702 patients who had Roux-en-Y gastric bypass (RYGB) surgery between March 2000 and September 2009 who had a diagnosis of migraine for which they were being medically treated. They noted that although gastric bypass generally improved or resolved migraine headaches among all study participants, those who developed their first migraines after becoming obese experienced the most improvement. About 80% had total resolution and 14% had partial improvement.
Of the patients who experienced their first migraine before the onset of obesity, 75% showed improvement after surgery (46% had total resolutions, 29% had partial improvement). Although morbidly obese individuals have additional medical issues associated with migraines, Samuel and colleagues found that the improvement in migraine symptoms following surgery was independent of the improvement of their migraine-associated issues such as depression, anxiety, or sleep apnea. Women with migraines associated with their menstrual cycles had similar improvement of migraines, as did others in the study.
“The association between migraine headache and obesity is controversial,” said Dr. Samuel. “Although some suggest that obesity is associated with migraine prevalence, others have only found a correlation between the frequency and severity of migraine headache and obesity. The effect of surgical weight loss on morbidly obese patients with migraines provides a unique opportunity to evaluate this association. The higher number of patients identified in this study cohort that developed migraines after obesity onset could suggest that obesity contributes to an increased risk of having migraines rather than merely exacerbating the symptoms.”