BACKGROUND: Migraine and obesity often coexist, and both generalized and central obesity may influence the frequency and severity of migraine attacks. This study aimed to investigate the association between obesity-related anthropometric measures and headache burden in individuals with migraine.

METHODS: This observational study was conducted at King Fahad Hospital of the University, Saudi Arabia, and included 186 patients diagnosed with migraine. Anthropometric data were collected at baseline and again after a minimum follow-up period of 12 months. Headache frequency and severity were evaluated, alongside clinical variables such as dietary habits and medication adherence.

RESULTS: Elevated body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were observed in 43.1%, 67.2%, and 41.4% of participants, respectively. At follow-up, 51.6% of patients reported an increase in headache frequency, with significantly higher BMI values among this subgroup (p = 0.018). Increased headache frequency was significantly associated with elevated BMI (p = 0.029), high WHtR (p = 0.023), and follow-up increases in both body weight and WC (p < 0.01). However, in multivariate logistic regression analysis, only follow-up increases in weight and WC remained marginally associated with increased headache frequency (OR: 1.94, 95% CI: 0.97–3.89; p = 0.05). Baseline values for BMI, WC, and WHtR were not independent predictors.

CONCLUSION: While obesity-related measures were prevalent among migraine patients, they were not independent predictors of increased headache frequency when behavioral factors were considered.  These findings underscore the need for a comprehensive approach to migraine management, emphasizing lifestyle modifications.  

KEYWORDS: Migraine, Obesity, Headache Frequency, BMI, Waist Circumference, WHtR