Abstract
BACKGROUND: Obesity is strongly associated with increased migraine frequency and severity, both of which contribute significantly to global disability. Bariatric surgery, through substantial weight reduction, has emerged as a potential therapeutic strategy for improving migraine burden. OBJECTIVE: To evaluate the impact of bariatric surgery on migraine frequency, severity and associated quality of life in patients with comorbid obesity and migraine. METHODS: This prospective cohort study included 48 patients diagnosed with migraine based on International Classification of Headache Disorders-III criteria who underwent bariatric surgery at Beni-Suef University Hospital. Migraine-related variables-monthly migraine days (MMDs), Visual Analogue Scale (VAS), Headache Impact Test-6 (HIT-6) and use of prophylactic medications-were assessed preoperatively and at 6 months postoperatively. RESULTS: Postsurgical evaluation revealed significant reductions in MMD (median change: 4, IQR (0-10.75)), VAS (median change: 2, IQR (0-4.75)) and HIT-6 scores (median change: 6, IQR (0.25-12)) (all p<0.001). The use of prophylactic medications decreased from 56.3% to 29.2% (p value <0.001). Significant positive correlations were observed between changes in body mass index (BMI) and improvements in MMD (r=0.369, p=0.010) and HIT-6 (r=0.407, p=0.004). Binary logistic regression analysis revealed that each unit reduction in BMI was associated with a 23.1% higher likelihood of clinically meaningful improvement in migraine. CONCLUSION: Bariatric surgery significantly alleviates the burden of migraine in obese individuals, supporting its potential as an adjunctive non-pharmacological treatment for patients with comorbid migraine and obesity.