• migraine;
  • obesity;
  • adult weight gain;
  • pediatric migraine;
  • body mass index

(Headache 2011;51:559-569)

Objective.— To evaluate the cross-sectional relationship between migraine and pregravid obesity; and to assess the risk of adult weight gain among women with history of a pediatric diagnosis of migraine.

Background.— Obesity, comorbid with pain disorders including migraine, shares common pathophysiological characteristics including systemic inflammation, and derangements in adipose-tissue derived cytokines. Despite biochemical and epidemiological commonalities, obesity–migraine associations have been inconsistently observed.

Methods.— A cohort of 3733 women was interviewed during early pregnancy. We ascertained participants' self-reported history of physician-diagnosed migraine and collected self-reported information about pregravid weight, adult height, and net weight change from age 18 to the 3-months period before pregnancy. Using pregravid body mass index, we categorized participants as follows: lean (<18.5 kg/m2), normal (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obese (30-34.9 kg/m2), severely obese (35-39.9 kg/m2), and morbidly obese (≥40 kg/m2). Logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results.— After adjusting for confounders, relative to normal weight women, obese women had a 1.48-fold increased odds of migraine (OR = 1.48; 95% CI 1.12-1.96). Severely obese (OR = 2.07; 95% CI 1.27-3.39) and morbidly obese (OR = 2.75; 95% CI 1.60-4.70) had the highest odds of migraines. Women with a history of diagnosed pediatric migraine had a 1.67-fold higher odds of gaining ≥10.0 kg above their weight at age 18, as compared with non-migraineurs (OR = 1.67; 95% CI 1.13-2.47).

Conclusion.— These data support earlier observations of migraine–obesity association among women, and extend the literature to include evidence of adult weight gain among women with a history of pediatric migraine.