The Effect of Bariatric Surgery on Migraines: a Systematic Review and Meta-analysis

Metabolic Aspects of Migraine: Association With Obesity and Diabetes Mellitus

“…Despite the unidirectional association between migraine and obesity (i.e., obesity produces an increase in migraine attacks) ( 7 ), we could suggest that there is a bidirectional relationship (i.e., migraine may also be a risk factor for exacerbating the development of obesity) (see Figure 1 ) since: (i) the current prophylactic antimigraine drugs (e.g., β-adrenoceptor antagonists, antiepileptics, antidepressants or Ca 2+ channel blockers) produce increases in body weight ( 123 ); and (ii) migraine is a disabling disorder ( 2 ), which can affect daily life and decrease the physical activity of those who suffer from migraine, while the lack of physical activity or a sedentary lifestyle is related to the development of obesity ( 72 ). As we mentioned before, weight loss after bariatric surgery may be beneficial in reducing the duration and severity of migraine attacks, and even in preventing them ( 128 , 129 ). Moreover, several studies have reported that weight loss related to lifestyle sliming strategies, such as physical activity and exercise and/or sports help reduce the frequency of migraine attacks or might exert a protective effect on individuals who suffer from it ( 145 – 147 ).…”

“…On the other hand, the association between migraine and obesity might have clinical consequences, as body weight management might contribute to migraine prevention. We recommend two recently published systematic reviews and meta-analyses by Di Vincenzo et al and Dang et al, which evaluated the effects of weight loss after bariatric surgery (and behavioral interventions, including diets) on migraine characteristics ( 128 , 129 ). It was shown that migraine frequency, disability, severity of the headache pain ( 128 , 129 ), and attack duration were all significantly reduced after bariatric surgery ( 129 ).…”

“…We recommend two recently published systematic reviews and meta-analyses by Di Vincenzo et al and Dang et al, which evaluated the effects of weight loss after bariatric surgery (and behavioral interventions, including diets) on migraine characteristics ( 128 , 129 ). It was shown that migraine frequency, disability, severity of the headache pain ( 128 , 129 ), and attack duration were all significantly reduced after bariatric surgery ( 129 ). Behavioral interventions were shown to have similar significant effects as surgery on these migraine characteristics, except for attack duration, in both adult and pediatric populations ( 129 ).…”

“…However, both reviews and meta-analyses are mainly restricted by their relatively small number of included studies. These limitations highlight the need for larger randomized controlled trials, including measurements of circulating inflammatory (adipo)cytokines, to understand potential underlying pathophysiological mechanisms and to gain further insight into the direction of this association and causality ( 128 , 129 ). In addition, we recommend the narrative review by Cervoni et al, that provides a general overview of behavioral weight loss treatments in migraine and obesity ( 130 ), and the review article by Razeghi Jahromi et al, that differentiates between nutritional interventions (diets) which, in general, seem to be effective in ameliorating headache/migraine ( 131 ).…”

The association between obesity and migraine and possible mechanisms of action: an integrative literature review

“…17,18 Recent studies prove this relationship and suggest some mechanisms for the interaction between the two diseases, such as inflammation 19 , persistent states of hyperleptinemia 20 , irregular hypothalamic function and sympathetic dysregulation. 21 Considering the above, the scientific literature was reviewed in order to better understand the mechanisms of interaction between obesity and migraine, in addition to their clinical implications and the consequences for the health of the individuals affected by both diseases.…”