Headaches and obesity

ABSTRACT Obesity and headache disorders are two very common conditions in the general population that have been increasing in incidence over the last decades. Recent studies have shown a significant relationship between obesity and headaches, particularly migraine, with an important role in whether the disease is chronic. On the other hand, no such association was found with tension-type headaches. Studies showing an overlapping of hunger-control pathways and those involved in the pathophysiology of migraine may justify the close association between obesity and migraine. Moreover, a secondary headache for which obesity is a strong risk factor is idiopathic Intracranial Hypertension (pseudotumor cerebri), with several studies showing the impact of weight reduction/bariatric surgery in the treatment of the disease. In conclusion, since obesity is a modifiable risk factor, it is important for physicians treating patients with headaches, and particularly migraine, to be aware of the association between these two disorders.

摘要：肥胖与头痛疾患（headache disorders）是普通人群中极为常见的两类病症，近数十年来，二者的发病率均呈持续攀升态势。近年已有研究证实，肥胖与头痛（尤其是偏头痛（migraine））之间存在显著关联，且该关联在疾病是否转为慢性的过程中发挥关键作用。另一方面，未发现肥胖与紧张型头痛（tension-type headaches）存在此类关联。已有研究表明，饥饿调控通路与偏头痛病理生理学相关通路存在重叠，这或可合理解释肥胖与偏头痛之间的紧密关联。此外，以肥胖为明确危险因素的继发性头痛为特发性颅内高压（idiopathic Intracranial Hypertension，又称假性脑瘤综合征，pseudotumor cerebri），多项研究证实减重/减重代谢手术（bariatric surgery）对该疾病具有确切的治疗效果。综上，鉴于肥胖属于可干预的危险因素，对于诊治头痛（尤其是偏头痛）患者的临床医师而言，充分知晓二者之间的关联具有重要的临床意义。