For Many, Weight-Loss Surgery Also Eases
WEDNESDAY, June 15 (HealthDay News) -- Severely obese patients
who suffer from migraines may see them fade or become less frequent
after having weight-reducing gastric bypass surgery, University of
Iowa researchers say.
In the three years following surgery, 70 percent of the patients
reported being migraine-free and more than 18 percent saw their
migraines reduced from five to two a month, the researchers
"The association between migraine and obesity is controversial," said lead researcher Dr. Isaac Samuel, director of the University of Iowa Obesity Surgery Program. "Some people say the risk for migraine is higher in obese people; others say the symptoms are worse," he said.
There could be a number of reasons why migraine is relieved by
gastric bypass surgery, including hormonal changes that occur after
the procedure or certain proteins produced by fat cells, Samuel
"Severely obese patients with migraine should be encouraged to have gastric bypass if they want relief of the symptoms," Samuel said. "In addition, people who are obese, but not severely obese, should be encouraged to lose weight if they have migraine."
The findings of the study were due to be presented Wednesday at
the 28th Annual Meeting of the American Society for Metabolic &
Bariatric Surgery in Orlando, Fla. Since the study is small and it
has not appeared in a peer-reviewed journal, its findings should be
Like all other operations, bariatric surgery carries some
medical risks, including. serious infections, internal bleeding,
blood clots, and death, according to the American Society for
Metabolic & Bariatric Surgery (ASMBA). The organization reports
that the overall risk of serious complications is about 4 percent
and the risk of dying is one in 1,000.
Weight-loss surgery is also expensive, costing from $17,000 to
$35,000 or more, depending on the type of procedure performed.
For the study, Samuel's team reviewed the medical records of 702
patients who underwent gastric bypass surgery between March 2000
and September 2009. In addition to being obese, the patients also
suffered from migraines. Of these patients, 81 were selected for
the current study.
The researchers found that gastric bypass surgery improved or
completely alleviated migraines in most patients. The most
pronounced effect was among those patients whose headaches started
after they became obese, the researchers note.
Of those who had their first migraine before becoming obese, 46
percent became migraine-free and 29 percent experienced some
improvement, Samuel's group says.
These findings were independent of problems associated with
migraine such as depression, anxiety or sleep apnea, the
Other causes of headache in obese people include pseudotumor
cerebri, or idiopathic intracranial hypertension, which is an
increase in pressure around the brain that can feel like a migraine
and may be caused by obesity. This type of headache also responds
well to gastric bypass surgery, the researchers noted.
Commenting on the study, Dr. Elizabeth Loder, chief of the
Division of Headache and Pain at Brigham and Women's Hospital in
Boston said that "this is an interesting observation but the data
seem quite preliminary."
In the absence of a control group, it is not possible to say
whether the surgery and ensuing weight loss really "caused" the
improvement in migraine, she said.
"Migraine is a condition that naturally waxes and wanes," Loder said. "Some of the improvement might simply reflect this variable disease activity. It is also the case that people who undergo surgery of any kind often report temporary improvement in headaches," she said.
Without a similar group of patients who did not undergo surgery,
it is not possible to distinguish among these possibilities, Loder
"In addition, it is unclear what is meant by complete, partial and no resolution, Loder said. "It would be very, very unusual for any treatment to cause complete resolution of migraine," she said.
Another expert, Dr. Richard B. Lipton, vice chairman of
neurology, and director of the Montefiore Headache Center at the
Albert Einstein College of Medicine in New York City, felt that the
findings underscored the need for further research.
"These data are compatible with the epidemiologic studies showing that obesity is a risk factor for migraine progression," he said. "In addition, there is another published observational study showing that migraine improves after bariatric surgery in proportion to the extent of weight loss. Randomized trials are badly needed."
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