Migraine Relief From Bariatric Surgery For Morbidly Obese Individuals

90% of morbidly obese patients who suffered frommigraines and underwent bariatric surgery achieved partial or total relief of their condition, researchers from the University of Iowa revealed at the 28th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS). Three years after their operation 70% of patients never had a migraine again while 18% experienced partial improvement - their frequency of attacks fell from five to two every month. 11% of them experienced no change.

Isaac Samuel, MD Roy J. and Lucille A. Carver explained:

"The incidence and severity of migraines was greatly reduced after bariatric surgery and weight loss, suggesting there are a number of people who are suffering from migraines who otherwise might not but for their excessive weight. "

The investigators gathered data from the medical records of 702 morbidly obese patients who had RYGB (Roux-en-Y gastric bypass) surgery between March 2000 and September 2009. All of them had been diagnosed as migraine sufferers and were being treated for the condition.

81 of them qualified for the retrospective study. Data were collected from institutional electronic medical records, or via telephone. They were followed-up after their operation for from 12 months to 8.5 years.

The researchers noted that the participants who experienced the most migraine relief tended to be those whose symptoms started after they had become obese. Approximately 80% had total resolution and 14% had partial improvement. 75% of those who suffered from migraines before they became obese experienced improvement after their bariatric surgery - 46% of them had total resolutions, 29% had partial improvement.

The researchers added that according to their data, patients' post-operative improvements in migraine symptoms were independent of migraine-linked issues, such as sleep apnea, anxiety or depression. The females whose migraines were linked to their menstrual cycles also experienced improvements.

Dr. Samuel added:

"The association between migraine headache and obesity is controversial. Although some suggest that obesity is associated with migraine prevalence, others have only found a correlation between the frequency and severity of migraine headache and obesity. The effect of surgical weight loss on morbidly obese patients with migraines provides a unique opportunity to evaluate this association. The higher number of patients identified in this study cohort that developed migraines after obesity onset could suggest that obesity contributes to an increased risk of having migraines rather than merely exacerbating the symptoms."

The most effective and long-lasting treatment for morbid obesity has been shown to be bariatric surgery. Morbid obesity means the person's BMI (body mass index) is at least 40.

Over 15 million people in the USA are morbidly obese, according to the American Society for Metabolic & Bariatric Surgery. Bariatric surgery can help patients lose from 30% to 50% of their surplus weight within six months of the procedure, and 77% of their excess weight within 12 months.

Bariatric surgery generally includes either laparoscopic gastric bypass or laparoscopic adjustable gastric banding (LAGB). After the operation the stomach's capacity to hold food is reduced, and/or the total number of calories absorbed is limited.

US health authorities estimate that annual obesity-related health spending doubled during the decade up to 2008 to $147 billion. If obesity rates in the USA continue their current trend, spending by 2018 will probably reach $344 billion annually.

"Roux-en-Y Gastric Bypass Achieves Substantial Resolution of Migraine Headache in the Severely Obese: a 9-year analysis of 81 patients" - PL 111
Yusuf Gunay, MD; Mohammad Jamal, MD, FACS; Alyssa Capper, BS; Anas Eid, MD; Debi Heitshusen, RN, Isaac Samuel, MD, FRCS, FACS, The University of Iowa, Roy J. and Lucille A. Carver College of Medicine