Background and Objective: Many studies have evaluated the risk of migraine headache
in obese persons, suggesting controversial conclusions. The aim of this systematic review and meta-
analysis of the observational studies was to clarify the association between migraine and obesity.
Methods: Scopus and PubMed electronic databases were systematically searched up to February
2019 for observational studies providing data dealing with migraine disorder in obese subjects, as
well as normal-weight controls. The random effects model was applied for assessing pool effect
size, and inter-study heterogeneity was evaluated by conducting subgroup analyses.
Results: Among 1122 publications, 16 studies (10 cross-sectional, 5 cohort studies and 1 case-control
study) were detected and were included in the meta-analysis. The pooled data analysis illustrated
an elevated risk of migraine headache (Prevalence ratio estimate = 1.29, 95% CI, 1.15 - 1.44, p
= 0.000) in obese individuals compared to normal-weight persons. Subgroup analyses revealed that
geographical distribution was an important source of heterogeneity (p = 0.04). Significantly greater
migraine prevalence was found in European and Asian patients, but no statistically significant relationship
with obesity was observed in American patients.
Conclusion: Based on a cumulative meta-analysis of available studies indicating an association between
migraine and obesity, obesity can be appropriately considered as an overall risk factor for migraine
headaches. Additional high-quality original studies considering frequency, severity, and duration
of headaches are required to clarify confident evidence.