Obesity has been recognized for many years to be a risk factor for cardiovascular disease and stroke. More recent studies have concluded that obesity in the teens increases the risk of developing multiple sclerosis.

Migraine now joins this list. Obesity is an important risk factor in converting from episodic migraine, meaning less than 15 headache days a month, to chronic migraine, meaning 15 or more headache days a month. Patients with chronic migraine have much more disability, utilize medical resources more, have a poorer quality of life, are more difficult to treat, and have higher rates of depression.

Why this should be so probably relates to the fact that fat cells are proinflammatory, secreting adipokines and other deleterious cytokines. Other risk factors in converting episodic to chronic migraine include inadequate treatment of individual attacks of migraine, lower socioeconomic status, smoking, and snoring. Likely, the increased risk with snoring relates to obesity.

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