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From the Departments of Neurology (M.E.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, and Montefiore Headache Unit (M.E.B., R.B.L.), Bronx, NY; and New England Center for Headache (M.E.B.), Stamford, CT.
Address correspondence and reprint requests to Dr Bigal, Department of Neurology, Albert Einstein College of Medicine, 1165 Morris Park Ave., Bronx, NY: e-mail: mbigal{at}aecom.yu.edu
Objective: To assess the influence of the body mass index (BMI) on the prevalence and severity of chronic daily headache (CDH) and its most frequent subtypes, transformed migraine (TM) and chronic tension-type headache (CTTH).
Methods: The authors gathered information on headache, medical features, height, and weight using a computer-assisted telephone interview. Participants were divided into five categories, based on BMI: underweight (<18.5), normal weight (18.5 to 24.9), overweight (25 to 29.9), obese (30 to 34.9), and morbidly obese (>35). The prevalence and severity of CDH, TM, and CTTH were assessed. Multivariate analyses modeling these diagnoses as a function of BMI were conducted.
Results: Among 30,215 participants, the prevalence of CDH was 4.1%; 1.3% had TM and 2.8% CTTH. In contrast with the normal weight group (3.9%), the prevalence of CDH was higher in obese (5.0% [odds ratio (OR) = 1.3, 95% CI = 1.1–1.6]) and morbidly obese (6.8% [OR = 1.8, 95% CI = 1.4 to 2.2]). BMI had a strong influence on the prevalence of TM, which ranged from 0.9% of the normal weighted to 1.2% of the overweight (OR = 1.4 [1.1 to 1.8]), 1.6% of the obese (OR = 1.7 [1.2 to 2.43]), and 2.5% of the morbidly obese (OR = 2.2 [1.5 to 3.2]). The effects of the BMI on the prevalence of CTTH were just significant in the morbidly obese group. Adjusted analyses showed that obesity was associated with CDH and TM but not CTTH.
Conclusions: Chronic daily headache and obesity are associated. Obesity is a stronger risk factor for transformed migraine than for chronic tension-type headache.
Disclosure: Data collection was conducted without financial support. Data analyses were supported by an unrestricted grant from Ortho-McNeil Neurologics (OMP). M.E.B. and R.B.L. have received prior research support from OMP in excess of $10,000. M.E.B. and R.B.L. have received honoraria in excess of $10,000 from education activities supported by OMP. M.E.B. and R.B.L. are on the migraine advisory board of OMP.
Received December 12, 2005. Accepted in final form March 29, 2006.
This article has been cited by other articles:
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M. E. Bigal, R. B. Lipton, P. R. Holland, and P. J. Goadsby Obesity, migraine, and chronic migraine: Possible mechanisms of interaction Neurology, May 22, 2007; 68(21): 1851 - 1861. [Abstract] [Full Text] [PDF]
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Y. Iwasaki, K. Ikeda, G. J. Gilbert, M. E. Bigal, and R. B. Lipton Obesity and migraine: A population study Neurology, January 16, 2007; 68(3): 241 - 241. [Full Text] [PDF]
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