Impact of bariatric surgery on headache frequency and severity and quality of life in patients with migraine: a prospective study.

BACKGROUND

Obesity is strongly associated with increased migraine frequency and severity, both of which contribute significantly to global disability. Bariatric surgery, through substantial weight reduction, has emerged as a potential therapeutic strategy for improving migraine burden.

OBJECTIVE

To evaluate the impact of bariatric surgery on migraine frequency, severity and associated quality of life in patients with comorbid obesity and migraine.

METHODS

This prospective cohort study included 48 patients diagnosed with migraine based on International Classification of Headache Disorders-III criteria who underwent bariatric surgery at Beni-Suef University Hospital. Migraine-related variables-monthly migraine days (MMDs), Visual Analogue Scale (VAS), Headache Impact Test-6 (HIT-6) and use of prophylactic medications-were assessed preoperatively and at 6 months postoperatively.

RESULTS

Postsurgical evaluation revealed significant reductions in MMD (median change: 4, IQR (0-10.75)), VAS (median change: 2, IQR (0-4.75)) and HIT-6 scores (median change: 6, IQR (0.25-12)) (all p<0.001). The use of prophylactic medications decreased from 56.3% to 29.2% (p value <0.001). Significant positive correlations were observed between changes in body mass index (BMI) and improvements in MMD (r=0.369, p=0.010) and HIT-6 (r=0.407, p=0.004). Binary logistic regression analysis revealed that each unit reduction in BMI was associated with a 23.1% higher likelihood of clinically meaningful improvement in migraine.

CONCLUSION

Bariatric surgery significantly alleviates the burden of migraine in obese individuals, supporting its potential as an adjunctive non-pharmacological treatment for patients with comorbid migraine and obesity.