What's New in Medicine

Yes! Dr. Richard Lipton and colleagues have shown that increased weight consistent with obesity, results in an increased risk of the transformation of episodic (occasional) migraine to chronic migraine (daily or near daily migraine headaches). Thus, it is important to maintain your Body Mass Index [BMI] in a normal weight range from 18 to 24. This can be done by diet and exercise.

Obesity and migraine are common and disabling disorders that are influenced by both genetic and environmental risk factors. Obesity and migraine with aura are clear risks to the neurovascular and cardiovascular systems resulting in potential stroke and/or heart attack.

Why is obesity a risk factor for increasing migraine? We know that several substances produced by fat in obese individuals are known inflammatory mediators [substances] that are also important mediators contributing to migraine. These substances include interleukins and Calcitonin Gene Related Peptide [CGRP]. These substances are felt to contribute to the increase in frequency, severity and duration of migraine attacks we see in patients who are significantly overweight. Is it also possible that just being mildly overweight will begin to contribute to these events of increased frequency, severity and duration of migraine? It has been shown that this influences not only adults but also children and adolescents.

It is also known that the levels of adiponectin are decreased in obesity. Why is this important? Because we know that low levels of this compound, adiponectin has an anti migraine effect. Thus, with increased levels of the substance it clearly may contribute and enhance the pain effects associated with migraine.

In obese patients there is also a dysfunction in orexins. Orexins are important in modulating pain and metabolism. More detailed discussions on these substances will follow in further articles since this is a very important aspect of the control of not only the neurovascular and cardiovascular risks of stroke and heart attack; but also diabetes.
Clearly, this is a topic that we will address in other aspects of the Seven Steps to Maintaining a Healthy Brain.

If you would like to read more about the relationship of weight, Body Mass Index [BMI] as they relate to the neurovascular and cardiovascular systems, I suggest that you start with reading the book “You on a Diet “ by Drs. Michael Roizen, and Mehmet Oz.

Reference: Bigal, M.; Lipton, R.; Holland, P.; Goadsby, P. Obesity, Migraine and Chronic Migraine; Neurology 2007; 68; 1851 1861.

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