Migraine and Obesity: Is There a Relationship? A Systematic Review and Meta-Analysis of Observational Studies

Many studies have evaluated the risk of migraine headache in obese persons, suggesting controversial conclusions. The aim of this systematic review and meta- analysis of the observational studies was to clarify the association between migraine and obesity.Scopus and PubMed electronic databases were systematically searched up to February 2019 for observational studies providing data dealing with migraine disorder in obese subjects, as well as normal-weight controls. The random effects model was applied for assessing pool effect size, and inter-study heterogeneity was evaluated by conducting subgroup analyses.Among 1122 publications, 16 studies (10 cross-sectional, 5 cohort studies and 1 case-control study) were detected and were included in the meta-analysis. The pooled data analysis illustrated an elevated risk of migraine headache (Prevalence ratio estimate = 1.29, 95% CI, 1.15 - 1.44, p = 0.000) in obese individuals compared to normal-weight persons. Subgroup analyses revealed that geographical distribution was an important source of heterogeneity (p = 0.04). Significantly greater migraine prevalence was found in European and Asian patients, but no statistically significant relationship with obesity was observed in American patients.Based on a cumulative meta-analysis of available studies indicating an association between migraine and obesity, obesity can be appropriately considered as an overall risk factor for migraine headaches. Additional high-quality original studies considering frequency, severity, and duration of headaches are required to clarify confident evidence.