MONDAY, March 28 (HealthDay News) -- Severely obese men and
women who have bariatric surgery may shed more than just excess
pounds: They may also reduce much of their pre-surgery risk for
experiencing disabling migraines, researchers say.
The finding is based on the results of a small study of obese
patients with a history of migraines. The patients went on to lose
an average of roughly 66 pounds by the half-year point following
either laparoscopic gastric banding surgery or Roux-en-Y gastric
bypass. And within that same timeframe, about half of the patients
cut the frequency of their migraines in half or more.
The study is published in the March 29 issue of the journal
Neurology.
"Obesity is thought to contribute to worsening of migraine, particularly for severely obese individuals, yet no study has examined whether weight loss can actually improve migraine headaches in these patients," study author Dale Bond, a researcher with the Miriam Hospital's Weight Loss and Diabetes Research Center, said in a journal news release.
"Our study provides evidence that weight loss may be an important part of a migraine treatment plan for obese patients," Bond noted.
About 28 million Americans struggle with migraines, the study
authors pointed out. The problem primarily affects women, and is
characterized by throbbing pain, typically confined to one side of
the head, lasting anywhere from four hours to three days, they
noted. Often recurring between one and four times a month, these
headaches are accompanied by nausea, vomiting and sensitivity to
light.
Although the exact mechanism driving migraines is not fully
understood, they are believed to be triggered by abnormal brain
activity that itself is set in motion by stress, particular foods
and a range of environmental factors. To date, there is no known
cure, though medications can sometimes help control severity and
frequency of attacks.
To explore the potential benefit of bariatric surgery on
migraines, Bond and his associates focused on 24 severely obese
patients with a history of migraines.
Most of the patients were women (88 percent), with an average
age of about 39, and more than 70 percent were white. All were
severely obese, with an average pre-surgery body-mass index (BMI, a
measurement that is based on height and weight) of 46.6. More than
half underwent the banding surgical option, according to the
report.
Although 70 percent of the patients were still characterized as
"obese" six months post-surgery, by that time point, patient BMI
had plummeted to an average of 34.6.
Questionnaires completed before and after the procedure revealed
that whereas the patients had experienced an average of 11 migraine
headaches over the prior three months leading up to surgery, that
figure dropped to less than seven by the six-month post-surgery
mark.
Specifically, 58 percent of the patients said they had fewer
headaches post-surgery. Another 17 percent experienced no change,
while a quarter said they actually had more frequent headaches, the
investigators found.
Overall, the greater the weight loss post-surgery, the greater
the apparent drop in migraine risk, the researchers reported.
Aside from frequency, migraine severity and the disabling
consequences that can result also seemed to dissipate post-surgery.
While half of the patients said their migraines were either
moderately or severely disabling pre-surgery (requiring medical
care), only 12.5 percent said the same was true six months
following surgery.
Commenting on the study, Dr. Frederick J. de la Vega, a
neurologist at the Scripps Memorial Hospital La Jolla in San Diego,
said that the observations raise a lot of as-yet unanswered
questions.
"It seems to be good news for these types of obese patients, of course," he said. "It's a win-win. But this kind of surgery involves some risks. And so I don't think people who suffer from migraines who are just a little chubby are going to go get bariatric surgery just to reduce their migraine risk."
"And secondly, there's probably a lot of factors interacting here to influence on migraines related to the benefits of shedding all those pounds," he noted. "Blood pressure changes, other metabolic changes, mood changes resulting from people feeling better about themselves, increased exercise participation after weight loss. And whether the lost weight has a secondary effect on the hormone levels of women, and how all of that might impact on migraines. All of these factors would have to be looked at."
More information
For more on migraine and obesity, visit the
American Headache Society.