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Obesity in the Pediatric Headache Population: A Multicenter Study

Authors

  • Andrew D. Hershey MD, PhD, FAHS,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Scott W. Powers PhD, ABPP, FAHS,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Timothy D. Nelson MA,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Marielle A. Kabbouche MD,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Paul Winner DO, FAHS,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Marcy Yonker MD,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Steven L. Linder MD,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Alma Bicknese MD,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Michael K. Sowel MD,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • William McClintock MD,

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • the American Headache Society Pediatric Adolescent Section

    1. From the Cincinnati Children's Hospital Medical Center—Neurology, Cincinnati, OH (A. Hershey and M. Kabbouche); University of Cincinnati, College of Medicine—Pediatrics, Cincinnati, OH (A. Hershey, S. Powers, T. Nelson, and M. Kabbouche); Cincinnati Children's Hospital Medical Center—Behavioral Medicine and Clinical Psychology, Cincinnati, OH (S. Powers and T. Nelson); Palm Beach Headache Center, Palm Beach, FL (P. Winner); A.I. DuPont Hospital for Children—Pediatric Neurology, Wilmington, DE (M. Yonker); Dallas Pediatric Neurology, Dallas, TX (S. Linder); St. Louis University, School of Medicine—Pediatrics, MO (A. Bicknese); University of Louisville—Pediatrics, Louisville, KY (M. Sowell); Children's National Medical Center—Pediatrics, Washington, DC (W. McClintock).
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  • Conflict of Interest: None

A. Hershey, Cincinnati Children's Hospital Medical Center—Neurology, 3333 Burnet Ave., MLC 2015, Cincinnati, OH 45229, USA.

Abstract

Objective.— To examine the prevalence of obesity, the relationship between weight compared with headache frequency and disability, and effect of weight change on headache outcomes within a pediatric headache population.

Background.— Headache and obesity are both common conditions in children and adults. Research in adults has suggested a relationship between the 2 conditions. This relationship has not yet been explored within a pediatric population. The effect of obesity and weight change on headache outcomes may have important implications for clinical care.

Method.— Data on height, weight, age, and gender, as well as headache frequency and disability, were collected on 913 consecutive patients at 7 pediatric headache centers, the body mass index (BMI) calculated and the BMI percentile determined. The same data were collected on patients seen at 3- (n = 213) and 6-month (n = 174) follow-up for comparative analysis.

Results.— The prevalence of overweight patients at initial visit did not significantly differ from the general pediatric population. BMI percentile was significantly correlated with headache frequency and disability at initial visit, although the correlations were relatively small. For children who were obese or at risk for overweight as initial visit, change in BMI was significantly positively correlated with change in headache frequency at 3- and 6-month follow-up.

Conclusions.— Obesity is associated with headache frequency and disability in the pediatric headache population. For children who are overweight, weight loss can contribute to a reduction in headaches over time. Clinicians should consider child weight status in providing care for pediatric headache.

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