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An expert explains: About Obesity and Episodic Migraines by Dr. Jan Dommerholt

Jul 10, 2014 4:29 AM

Episodic and chronic migraines are common kinds of headaches. While chronic migraines get much attention, only about 2% of the general population suffers from chronic migraines. On the other hand, episodic headaches, defined as a condition with up to 14 migraine episodes per month, are much more common with a prevalence of 12% to 15%.

A recent study found that obesity, which is an increasingly common condition throughout Western societies, appears to be linked to episodic migraine headaches, especially in women or younger people under 50 years of age. Interestingly, the risk of episodic migraine did not increase in obese men over 50 years of age.

It is not entirely clear how obesity and episodic migraine headaches are related to each other. Some researchers speculated that the hypothalamus may play a key role. The hypothalamus is the part of the brain, that regulates whether someone wants to eat. The hypothalamus is activated during migraine headaches and is also associated with obesity. Others suggested that people with episodic migraines may live more sedentary lifestyles, leading to becoming overweight and obese. It is also conceivable that certain inflammatory proteins, that are commonly seen with obesity, may be linked to episodic migraines.

In summary, now that there is a link between obesity and episodic migraine headaches, especially in women, it is important that people suffering from episodic migraines participate in regular exercise to control their weight, and follow healthy and balanced diets.

Dr. Jan Dommerholt

Are you participating in regular exercise? Are you watching your diet? What helps you dealing with migraines?

Jul 10, 2014 7:54 AM

Is it being considered that this link between migraines and obesity is due in part to the patient's migraine/headache medication causing their weight gain? I was underweight most of my life ( 5'9" @ 115) until gaining 80 lbs rapidly with prescribed headache medicine.

Jul 11, 2014 6:33 PM

why does it always go to oh loose weight it will go away, oh you need to be very active and it will go away. well all that got me was sicker, more pain, more movement problems. and a lot more. opps sorry ranting. about how doctors have no clue.

Jul 14, 2014 11:09 AM

i understand the thought process that losing weight and exercising will help with migraines. However, someone like me (migraines, IIH and FM), it's very difficult to exercise without having the negative side effects that result from my condition. many times I feel like I am between a rock and a hard place as I know what needs to be done but for me, the results don't outweigh the benefits. if I were not allergic to NSAIDS, I could probably do more exercising. sound like an excuse? don't judge until you've walked in someone's shoes.

Jul 14, 2014 3:11 PM

I became over weight because of the pain.....now I'm told the reason for my issues is because of my weight. Seems there's no winning

Jul 16, 2014 9:51 AM

Agree Hannah, I put on significant weight after my injury which severly limits ability to undertake the extent of physical activities I used to, it's a vicious cycle that is hard to accept. I feel like I was cut down whilst in peak fitness health, also many of the medications will also make you drowsy, so not feeling like exercise, even gentle stuff like walking, or they have the side effect of weight gain.

Jul 18, 2014 10:31 PM

it's all well and true but when your given medication for cronic pain and depression (amitrytaline),that steadily makes you put on weight and nerve pain (pregabalin), that has the same affect on weight gain, how are you to balance the need for pain control, manage health problems, trying to have a normal life, controlling food intake and exercise? specially when your in pain and range of movement is limited due to a health problem?
people's situations and circumstances are not as simplistic as pain+exercise=prevent obesity+reduced pain! As for migraines, there are a whole host of triggers and patterns, not to mention it not being migraine after all, like Idiopathic Cranial Hypertension etc!
Pain management needs to take different tack that is more person centred than one size fits all approach, because no two cases are the same! I as a person have ideas about what I want to achieve in terms of treatment for pain, I want to be able to keep mobile as long as possible and reduce pain as much as possible, so I can work and have some normality. I know I might have to endure a bit of pain to do that.
My priorities here are,
1, reduce or eliminate pain for most of the time
2, stay mobile as long as possible
3, support myself as long as possible
4, prevent weight gain
what I also want is for me to be realistic and more importantly, my doctors to be realistic about what can be achieved and what I can realistically be expected to achieve from treatment and pain management! instead it seems like the focus of pain management is pain treatment with the focus being pain reduction or elimination.
I have facet joint damage in my lower spine, three bulging discs in my neck and osteoarthritis in the rest of it. No amount of weight loss and exercise will change or reverse that damage and it may in fact add to the damage in the long run. while I m not happy with the weight gain and can see more weight would perhaps add to the problem, weight loss is quite a bit back down in my priorities list. infact if truth be known, it's hard enought to go to work, food shop, house clean etc etc in a normal day as well as manage pain, except pain management comes before all that because sometimes pain is all consuming and there's nothing left for anything else!
ultimately, we all want to be pain free but the reality is that's not always possible or that it's at a price to other areas of a pain sufferes life. weight control and exercise is just another thing for me to juggle when I m struggling to handle what I already have.
we are people as well as patients, pain does not define us it's just one part of our individual story and to really help us you need to look at the whole picture if you want to treat us!

Personally, I find comments about weight and weight control feels more like a criticism or judgement, but that's just me!

Jul 19, 2014 8:13 PM

cried when I read this. feel very stressed and angry. I've suffered migraines for years now. well before I put weight on. I've also got neck and lower back problems. been on going for nearly 17 years now. I was reasonably slim until a massive back muscle spasm put me in hospital three years ago. they put me on pregabalin and since then I've piled weight on. I try to exercise as much as I can but am hindered by my pain. I'm on quite a few different meds that can cause headaches and weight gain but it seems the pregabalin got me. I eat a reasonably healthy diet to. so to be told it's my weight that's causing my migraines upsets me a lot. I've also been told that if I lost weight my pain would be much less. my pain was there before the weight gain. I know the extra weight isn't doing me any good but without the pregabalin I wouldn't cope with the nerve pain. it does concern me a lot as we have heart problems in the family. I have discussed this with various doctors and consultants but they're said there's no alternative meds to take. I feel that comments about headaches/migraines and weight control are very judgemental.

Jul 19, 2014 10:13 PM

Hi LaviniaGrace44,
I too suffer from migraine, since about the age of 13. After trying many Meds specific to migraine, Imitrex etc, I have found surprisingly that EXCEDRIN takes care of most of my migraine pain. EXCEDRIN has really been a God-send for me.( just my experience ). You are right, there are many judgemental people who just can't understand what having chronic pain every f$&@king day is all about.
All you can do is the best you can do, no more, and, no less.


Jul 20, 2014 5:27 PM

thanks mak. nice knowing there's someone out there that understands. I have tried a variety of different meds for migraine. because of the meds I take for my other pains I have to have something prescribed by the gp. the pharmacist won't sell me over the counter meds for migraines because I'm on a high dose of morphine. I have found that a cool darkened quiet room and sleep does me good once I've taken something, on its own it can take several days to go. I need to be about for my kids so need symptoms brought under control fairly quickly. having someone find out what's causing them would be great. but I'm very doubtful that's going to happen any time soon. it would be great if I could be the pre-pain me, where my kids have a mother that's there for them instead of one that's sleeping or unable to take them to school cause the pains got to much. none of the specialists I've seen seem too look at that, they just want to concentrate on "the fat me" and make me feel a whole lot more lousy than I do already. my gp is great. there's some understanding there but it's the specialists that need to understand and listen. my gp and friends keep telling me as you have- you can only do what you can do, no more and no less. guess it's something I'm gonna have to work on as I always feel as if I should be doing more, even when I can't. aparently I need a much more positive attitude.

Jul 21, 2014 11:16 AM

There were some issues raised and questions asked about this article. Dr. Jan Dommerholt has read your posts and is writing back to you. Here is his reply:

"The possible link between obesity and migraines triggered some strong reactions and I would like to take the opportunity to briefly respond to some of the concerns.

First, we need to acknowledge that there are many causes of being overweight and many possible complications. Indeed, many medications used for chronic pain conditions can cause severe weight gain. The study I reviewed did not state anything about cause and effect and therefore, it is not correct to assume that excessive weight would be the cause of migraines. The only thing that was established is that there is a possible correlation between obesity and migraines. That does not mean that obesity is a cause of migraines as several comments implied. It also does not mean that you just have to lose weight! Nothing is that simple.

Dodare and others mentioned that comments about weight and weight control feel judgmental or like criticism. While that often may be the case, I do not agree that the study or my comments placed any blame or were judgmental – it was certainly not meant this way. Rather to the contrary, it is important to understand what possible contributing factors may play a role in an effort to come up with better management strategies.

If weight gain started after the onset of the migraines, perhaps because of medications, the extra weight probably does not help. Gaining weight because of medications is very difficult to combat if not impossible. The comment that people with episodic migraines may live more sedentary lifestyles is also not meant as a criticism. Rather, I acknowledge that pain is usually the main reason why people become more sedentary.

There is no question that weight gain and migraine pain often make it very difficult to start exercising, but I do think that seriously attempting to start a very gentle exercise program is always important even if initially you can only walk for as little as 5 minutes. Try to increase the time or distance next week and slowly build up your exercise tolerance."

Jul 21, 2014 9:44 PM

why are my replys being blocked?

Jul 22, 2014 10:40 AM

@Dodare: We have not blocked any of your replies. Did you have some technical difficulties? Could you write to contact@catchmypain.com what the issue is or was, so we can take a look at it? Thank you!

Jun 21, 2015 6:51 PM

I've been part of a Slimming World group since January 2014. I lost 3 stone. I joined and stopped smoking, all because I thought it would help make me better. If anything, my condition worsened over time and now I'm the worst I've ever been. I lost weight, I deteriorated, I became depressed and fed up, now I've put some weight back on. How are we supposed to be active and healthier consistently when some days I cannot get out of bed. Let alone cook and exercise. Living in sufh a constant viscious cycle sucks and I refuse to be told it is my own fault. :-(

Jun 21, 2015 7:40 PM

Just out of curiosity, what is the sample size of the study?
Did you compare different age groups, and make sure to include teens and kids with chronic pain?
Also, did you look into what effect being skinny had on the body?
I'm pretty skinny, and when my pain got worse I had chronic nausea, couldn't move, and was getting close to starvation.
Have the researchers looked into the factor Iodine used to play into diets?
Older generations likely would have had more in their food, could that contribute to weight?

Jun 21, 2015 10:00 PM

Well I blame the doctors & scientists who have genetically modified all our sources of foods & plant life, and added preservatives for shelf life. You cant even buy heirloom seeds for garden plants anymore, they're all modified to be better according to the world of science. Even meds which comes from plants are affecting us the same. This modern world of fast foods and microwaveable foods is horrible for us. When I was growing up in the 60's-70's, the majority of our fruits & vegetables came from someone's garden or farmers market. We didn't have all the fast food and microwaveable foods pumped full of shelf life preservatives. Nor were our meat sources that way, but they are today. Looking back at pictures and movies from those days (recently watched replay of Jaws) you see almost everyone was slim & trim. Today we're just the opposite. Meds for asthma, allergies, thyroid, chronic back & neck pain, migraines, & depression all contributed to my 50+ lb gain in 5-6 years, along with inactivity due to deteriorating health. We are fighting against a very hard battle that seems to be a no win for the patients. This is just my opinion. 🙏🌼

Jun 22, 2015 12:37 AM

Wow. I guess I should gain weight so that I can explain my migraines. :P

During ww2 soldiers were given the first version of MRE's. And while they ate those, the women at home went to work. After the war, the soldiers brought home the taste for this food, people were fascinated by it, more women were at work, not making dinner, and since convenient food was, well, convenient, it became popular quickly.

So between convenient food, the advent of microwaves, and fast food (thank Ray Kroc), Americans embarked on quick eats.

Marketing and capitalism has led to the manufacture of processed food--it is very important to keep the consumer hungry, and get him addicted to the food so that he keeps coming back. These foods are high in what we crave biologically. Natural food is not high in salt, fat, or carbs. Processed food is--and if it's accessable (and since we're pretty much wired to have a huge endocrine reaction to it) people eat a lot...

In the US, most food is not local. We eat better than at any time in history. Even kings could not get fresh fish. Fruit was not accessible year round. Many foods were not available. The fact I can go to Mitsuwa and buy farmed salmon from Scotland, mushrooms from God knows where, Japanese food that I have no idea what they are, but they're not made in the US... The fact that I can go to Von's and buy (sort of) fresh milk anytime I want... That there's breakfast cereal... Etc is a modern "marvel"... The distribution process that gets me strawberries out of season or fruit from South America is unprecedented in history.

Yes. I do believe that there are significant problems with our food system. I don't believe it's a conspiracy. I believe it's capitalism. Gotta make money. Sell a product. A good drug dealer makes his buyers addicted--so too does crappy food.

The way animals and vegetables and fruit are produced are not good for farmers or consumers--but they are good for "the bottom line".. The fact that a chicken is born and grown to a slaughter weight in (I believe) 48 days -- and this is a chicken with so many hormones, bred to have a huge breast--so big it can't really walk--is completely ridiculous. Pigs and cows are "grown" in factory conditions. It is not natural for cows to eat corn--and most people are so used to corn fed beef that grass fed beef tastes weird.

Corn is the mono crop of this country--corn soy a couple of other things. Most of it goes for industrial use and animal feed--not people food. But if ere were a blight, cows would have no food. And neither would cow eating people.

All of this--the treatment of farmers, animals, the roundup on crops, the pesticides on apples, lead to higher yields. On the one hand, higher yields are higher profits. On the other hand--part the reason for higher yields is because there's too many people. Sustainable meats like rabbit (use less land, less water, less feed per pound of meat than any other--also leaner and healthier) are not the custom in this country. The rapid decimation of land and of necessary creatures like bees makes it even more necessary for farmers to use other means to maintain their ability to make a living.

Companies like Monsanto are the problem. There are shadow companies and shadow people (proctor and gamble, du pont) who make huge profits off this crap. While yes, the government does have some responsibility, the bottom line of making profit keeps this cycle.

While it's easy to criticize--I have no ideas. I don't think we should be socialists. Because people strive under pressure, and when cut down (like in a kibbutz), tend to become lazy. No extremes I think are helpful. I believe I have a responsibility to be educated about what I eat. You can say it's expensive to eat healthfully. I live in a poor part of LA--even here, there's a farmers market (which I don't go to, actually). I make a choice when I go to the supermarket. Choose the behavior--choose the consequences. I go to Von's because it's easy and I can. I go to Von's because it's cheap and its a real pain the ass to drive somewhere and get something else.

Humans have been breeding animals and plants for thousands of years--a form of Genetic modification . While genetic modification in a lab can lead to unknown problems--it's been going on a bigger way than I think is even measurable. Genetic modification means plants don't get diseases and need less pesticides. It means higher yields. It means apples that look appealing in the store. People like bright apples, orange dried apricots (the treated ones), red tomatoes (even if they're tasteless). These things sell.

Pharmaceuticals are way overdone. And the general population has less say in that. Doctors publish studies according to who pays them The whole thing revolves around money and profits. New drugs may come out that are less effective than old drugs--but they are marketed, and doctors prescribe them. Recently, a women's "Viagra" was FDA approved. This drug apparently is not particularly effective. scientists have (unsuccessfully) been trying to make a drug for "helping" women sexually, but at the end of the day--people are crying foul, saying its a feminist issue and that women are being left out... So the drug passes because of pressure from consumer groups (that would be us--sort of) even though it's shitty and may cause crappy side effects.

Pfizer came out with a new version of OxyContin just before their patent expired--to get a New patent. And to get more American addicted so that they can make and sell more drugs. This is the bottom line.

Damage and liability is not really applicable to a corporation-and therefore, the people responsible for bad marketing, getting around regulations, etc, are not held responsible ... You can't sue Monsanto--not in any kind of effective way.

The link between migraines and obesity might simply have to do with consuming toxins. More food is more toxins. The environment is polluted. Food is polluted. (And I live in LA, I know.. :P)... And when the shit hits the fan, when there comes a disease or no bees or contaminated water or a problem with gasoline that puts the trucking industry on stop--life will get really crazy really fast. I don't want to be around for that. We have developed this system and are dependent on it. It's crap.

It's not something that came out of nowhere. It's the American way. We are a country than manipulates everything and everyone. And without critics, we won't change. Most Americans do not have money, but there's idea that maybe tomorrow. Might as well spend today--cause tomorrow either doesn't matter or the lottery is great...

The post for this thread was not judgmental, though it was unnecessary. There's no point is saying any of that since the link between obesity and migraines is vague, at best. Unrelated things can be made to relate to one another through the power of statistics. Anything can be predicated--as long as the right cherry picking takes place.

I a, not advocating that people should believe something in particular. Without divergent opinions, there would be no growth, no interest. I believe that in order to know my own beliefs, I have to know, understand, and acknowledge what I don't necessarily agree with. What I believe and don't believe is so dependent on my context that without examination--it's pretty arbitrary.

I don't believe that money is bad or that business is bad.

Bad business and greed--pure greed--are evil.

Jun 22, 2015 12:46 AM


I do not believe in victimhood. I do not believe in a culture of victimhood.

I was raised in house where being victim was the way to go. I did it for a long time, blaming other people.

Then one day, I looked in the mirror and discovered I have responsibility.

I may still be angry and bitter, but there's progress.

Like Ghandi said--be the change...

Jun 28, 2015 12:22 AM

I am so absolutely FED UP with doctors saying that practically everything you can imagine being wrong with you is linked to being obese. I have been large my entire life. I was always heavy even as a little kid and believe me, when I was young, there was no sitting around the house, there were no cell phones, video games, etc... We went out and stayed out all day running, playing frisby, walking virtually everywhere we went, roller skated, went ice skating, horseback riding, etc... I was active in school, playing volley ball, basket ball, softball, etc. As I got older and went through puberty, I got even heavier. When I was 29 I was diagnosed with Grave's Disease. I was having panic attacks, couldn't sleep for days on end, felt like I had to constantly run around the block even though I was exhausted from not being able to sleep. I went to the doctor who referred me to an endocrinologist and was told the thyroid had to go. (I did go through with that procedure after I got a second and third opinion which all came back the same). After the procedure, it took 2 years to regulate me, it threw my body into menopause and I was all messed up. The GYN put me on Progestyn and my period came back for one month and then not the next. So, another course of progestyn. Period came back once and then not again. I said I would no longer take hormones because I wasn't taking a chance on getting cancer, etc.. I was without a period for almost 13 years and then one day it just came back. I have been to the GYN and there are no abnormal PAP Smears and everything else is fine where that is concerned. I have Fibromyalgia, Long Thoracic Nerve Palsy, Degenerative Joint Disease, Degenerative Disc Disease, Cervical Spondalytic Myelopathy, Thoracis Scoliosis, Severe Lordosis, several herniated discs in my spine (almost every disc in the lumbar spine is herniated or bulging). I have had neurostimulator implants in my cervical spine revised five times and also have had several cervical laminotomies that were performed at the same time and as the neurologist described them, they were aggressive to try to make room to allow for the inflammation that was ocurring not to interfere with the nerves and cause me more pain. I have no recognizable joint in my left shoulder and it hangs down approximately 4 inches lower than the right one and the right shoulder is now following suit. It started with my scapular winging because of the long thoracic nerve palsy and then snowballed from there. So, now the right shoulder is doing the exact same thing and they want to do a pectoralis major transfer like they did on the left and I don't want to go through it because it failed on the left side. I have had my left knee operated on approximately 4 times, cleaning out the torn tissue, repairing the tears in the tendons and also removing the meniscus because is was shredded and I am bone on bone. I have had injections and have been told by several doctors I need to have my knees replaced. I also have a tear in my right achilles tendon which is causing me horrible pain as well. I have migraines two to three times a week that come up from my neck, up behind my ear and then BAM, migraine. They last anywhere from a few hours to a few days and there is NO medicine that makes them better. I have been also diagnosed with RSD, CRPS and TMJ. I have NO high blood pressure, NO diabetes, NO heart or lung problems, NO liver problems, etc... All autoimmune issues that cause a shitload of horrible pain that is 24/7/365 with no breaks and the meds I am on only take the edge off that I can somewhat function. I can't work any more because I can't tell what each day will bring and if I can go out, it is not for a very long period of time. I eat clean, no gluten, no junk, I dont drink alcohol. I eat very bland. Mostly broiled chicken with lemon and pepper with dark leafy greens and a sliced boiled potato. Even that is a big meal for me. I generally am not hungry for breakfast and cannot eat if I am not hungry. I do have a greek yogurt in the mid morning with a protein bar. Lunch usually a romaine lettuce leaf with cut up chicken, onion and celery in it and wrap it in the leaf and thats lunch. Dinner is generally a chicken cutlet, veggies and that's all. Sometimes I dont even have breakfast or dinner, I just eat lunch. I just recently lost 90 pounds and NO, I don't feel better. My knees are the same and so is my spine and all the other crap that hurts. STOP blaming obesity for everything that is wrong with people. Just because the medical doctors and scientists can't figure out what causes certain things to occur, don't jump on the overweight bandwagon, it really makes me sick. I am sorry that this is so long winded and rambles (Actually, no, I'm NOT sorry because it needed to be said, it's how I feel). You all need to go back to the drawing board and think things through because there are MANY people in the world with the diseases and issues I described that I have myself that are thin and nowhere near being overweight. Think about it!!!!!

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