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The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

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Volume 16 Supplement 1

1st Joint ANIRCEF-SISC Congress

Open Access

O050. Chronic daily headache and body mass index: a meta-analysis of observational studies

  • Cindy Tiseo1Email author,
  • Diana Degan1,
  • Raffaele Ornello1,
  • Amleto Gabriele1,
  • Francesca Pistoia1,
  • Antonio Carolei1 and
  • Simona Sacco1
The Journal of Headache and Pain201516(Suppl 1):A64

Published: 28 September 2015


Body Mass IndexObesityMigraineObservational StudyWeight Management


Many studies have investigated the association between chronic daily headache (CDH) and normal weight, pre-obesity, and obesity, with controversial results. A meta-analysis of observational studies was conducted in order to clarify the association between CDH and body mass index (BMI) categories.


Studies published up to April 2015 about the association between CDH and BMI were systematically searched from multiple electronic databases. We included in the analysis observational studies in the English language with CDH as outcome variables, and pre-obesity or obesity as compared with normal weight as exposure variables. Only the studies which defined BMI categories according to the World Health Organization criteria for the Western population were included (underweight, <18.5 Kg/m2; normal range, 18.5-24.9 Kg/m2; overweight, ≥25.0 Kg/m2; pre-obesity, 25.0-29.9 Kg/m2; class I obesity 30.0-34.9 Kg/m2; class II obesity 35.0-39.9 Kg/m2; class III obesity ≥40.0 Kg/m2). Pooled adjusted effect estimate (PAEE) with 95% confidence interval (CI) was calculated to examine the strength of the association using random-effects models.


Out of 2,022 records, 4 studies[14] met the selection criteria and were included in the meta-analysis. The pooled analysis suggested an increased risk of having CDH in obese subjects (PAEE 1.48; 95% CI, 1.10; 1.98; p = 0.009) as compared to normal weight subjects, while the risk in pre-obese subjects was not different when compared to that of normal weight subjects (PAEE 1.13; 95% CI 0.93-1.39; p = 0.223) (Figure 1). Data analysis according to BMI categories found that subjects with grade II-III obesity had a higher risk of CDH (PAEE 1.94; 95% CI, 1.50-2.51; p < 0.001) than normal weight subjects, while grade I obesity was not associated with a higher risk of CDH (PAEE 1.05; 95% CI 0.43-2.59; p = 0.909) (Figure 2).


According to this meta-analysis of observational studies there is an association between CDH and moderate and severe obesity. This association suggests that body weight management may be a viable strategy for the prevention of chronification in patients suffering from both migraine and tension-type headache.

Authors’ Affiliations

Department of Neurology, University of L'Aquila, L'Aquila, Italy


  1. Scher AI, Stewart WF, Ricci JA, Lipton RB: Factors associated with the onset and remission of chronic daily headache in a population-based study. Pain. 2003, 106 (1-2): 81-89.View ArticlePubMedGoogle Scholar
  2. Bigal ME, Lipton RB: Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology. 2006, 67 (2): 252-257. 10.1212/01.wnl.0000225052.35019.f9.View ArticlePubMedGoogle Scholar
  3. Winter AC, Berger K, Buring JE, Kurth T: Body mass index, migraine, migraine frequency and migraine features in women. Cephalalgia. 2009, 29 (2): 269-278. 10.1111/j.1468-2982.2008.01716.x.PubMed CentralView ArticlePubMedGoogle Scholar
  4. Santos IS, Goulart AC, Passos VM, Del Carmen Molina M, Lotufo PA, Bensenor IM: Obesity, abdominal obesity and migraine: A cross-sectional analysis of ELSA-Brasil baseline data. Cephalalgia. 2015, 35 (5): 426-36. 10.1177/0333102414544978. Epub 2014 Aug 12View ArticlePubMedGoogle Scholar


© Tiseo et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


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