A Retrospective Analysis of the Impact of Bariatric Surgery on the Management of Chronic Migraine

Obes Surg. 2021 May;31(5):2040-2049. doi: 10.1007/s11695-020-05204-w. Epub 2021 Feb 11.


Purpose: To investigate the association of the two most common bariatric surgical procedures, vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB), with sustained remission from chronic migraine.

Materials and methods: Using IBM MarketScan® research database to examine inpatient and pharmacy claims from 2010 through 2017. A cohort of bariatric patients with chronic migraine was created using inclusion and exclusion criteria. Remission was defined as no refill of first-line migraine medication for 180 days after a patients' medication was expected to run out, and recurrence as medication refill after at least 180 days of remission.

Results: Of 1680 patients in our cohort, 931 (55.4%) experienced remission of migraine. Of these, 462 (49.6%) had undergone VSG, while 469 (50.4%) had undergone RYGB. Patients who underwent RYGB had an 11% (RR = 1.11, 95% CI: 1.05, 1.17) increase in likelihood of remission of migraine and a 20% (RR = 0.80, 95% CI: 0.63, 1.04) decrease in likelihood of recurrence of migraine compared to patients who underwent VSG. Older age group, higher number of medications at time of surgery, and female sex were associated with a decreased likelihood of remission.

Conclusion: Type of bariatric procedure, age, number of medications at surgery, and sex were the most important predictors of migraine remission after surgery.

Keywords: Bariatric surgery; Chronic migraine; Impact.

MeSH terms

  • Aged
  • Bariatric Surgery*
  • Female
  • Gastrectomy
  • Gastric Bypass*
  • Humans
  • Migraine Disorders* / drug therapy
  • Obesity, Morbid* / surgery
  • Retrospective Studies