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 肥胖与头痛疾患是普通人群中极为常见的两类病症，近几十年来其发病率持续攀升。近期研究表明，肥胖与头痛（尤其是偏头痛）之间存在显著关联，且该关联在疾病是否慢性化的过程中发挥重要作用。另一方面，紧张型头痛与肥胖未发现此类关联。已有研究证实，饥饿调控通路与偏头痛病理生理机制相关通路存在重叠，这或可合理解释肥胖与偏头痛之间的紧密关联。此外，以肥胖为强风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），多项研究显示减重或减重代谢手术对该疾病具有明确治疗效果。综上，由于肥胖是可干预的风险因素，因此为头痛（尤其是偏头痛）患者诊疗的医师需知晓这两种疾患之间的关联，这一点至关重要。