Body Mass Index and The Brain in Pain: Influence of BMI Level on Migraine Patients Seen at a Large Tertiary Headache Center
Gabriella O'Fallon, Mason Dyess1, Helen Haley, Arnav Narula, Daniel Krashin2, Silvie Belaskova, Natalia Murinova3
1UW Medicine, 2University of Washington, 3University Of Washington

Quantify BMI in migraine patients referred to the tertiary headache clinic at the University of Washington. Analyze headache characteristics and migraine comorbidities as they relate to BMI.


Scientific evidence has shown that obese individuals have an increased risk of migraine chronification, as well as an increased risk of headache comorbidities. This study aims to quantify the BMI of patients referred to our headache clinic and analyze if a raised BMI is associated with increased migraine chronification and other common comorbidities.


Patients referred to our clinic complete a detailed intake questionnaire prior to their first visit. This questionnaire asks about headache characteristics, sleep, depression, anxiety, and stress among other data. All patient data are analyzed by headache providers. After each patient’s visit, their BMI and ICHD-3 headache diagnosis are added by a provider.


Our study shows n=3611 unique patients were diagnosed with migraine, and had BMI results available. Statistical analysis shows that BMI is higher in chronic migraine. Patient with BMI ≥ 30 compared to normal BMI have more headache days per month and greater headache severity. Patients with BMI ≥ 30 have higher perception of stress scores (P<0.0001) that correlates with higher anxiety, have higher PHQ4 (P<0.0001) that correlates with depression than patients with a normal BMI. Patients reporting sleep problems have higher BMI than patients not reporting sleep problems.


Our data support our expectation that BMI ≥ 30 compared to normal BMI correlates with increased migraine chronification, increased headache days per month, and increased headache severity. BMI ≥ 30 compared to normal BMI also significantly correlates with measures of migraine comorbidities, such as anxiety, depression, and difficulty with sleep. Normalizing BMI may be protective against migraine chronification and improve all migraine comorbidities.