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June 20, 2025The Journal of Headache and PainOpen Access

After multivariable adjustment, BMI and obesity were inversely associated with annual bout frequency (BMI per 1 kg/m2 OR: 0.92; 95% CI: 0.86–0.98 and obese OR: 0.52; 95% CI: 0.32–0.86).

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Why the study?

Despite evidence of obesity's negative influence on migraine, its impact on cluster headache disease activity remained unexplored.

Does higher BMI or obesity reduce lifetime bout occurrence and annual bout frequency in patients with episodic cluster headache?

Population

316 patients with episodic cluster headache from a multicenter registry

Comparison

BMI and obesity (BMI ≥ 25.0 kg/m2) vs lower BMI

Design

Multicenter cross-sectional study

Authors

BKByung‐Su KimMLMi Ji LeeBKByung-Kun Kim

Discussion

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Overview

Should not yet change weight counseling in ECH; leaves open an inverse BMI–bout link that challenges the migraine-obesity paradigm.

Structured PICO

Does higher BMI or obesity reduce lifetime bout occurrence and annual bout frequency in patients with episodic cluster headache?

P
Population
316 patients with episodic cluster headache (ECH), with ≥ 2 years of duration of CH disease and ≥ 2 times of lifetime bout occurrence, mean age 37, 15.8% female, from the Korean Cluster Headache Registry.
I
Intervention
Higher Body Mass Index (BMI) and obesity (BMI ≥ 25.0 kg/m2)
C
Comparator
Normal weight (BMI 18.5–22.9 kg/m2) or lower BMI
O
Outcome
Odds ratios (ORs) of BMI and obesity for quartiles of lifetime bout occurrence and annual bout frequency

Higher BMI and obesity are inversely associated with lifetime bout occurrence and annual bout frequency in episodic cluster headache, suggesting that neurobiological aspects of obesity may suppress cluster bout periodicity.

Limitations

  • Cross-sectional design lacks a causal relationship
  • Recall bias for lifetime bout occurrence, onset of CH, and total disease duration
  • Results may not directly apply to populations of other ethnicities or cultures
  • Prevalence of obesity was somewhat lower compared to the general population
  • Impact of obesity on chronic CH could not be adequately investigated due to low proportion of CCH patients

Cite This Study

Kim et al. (2025) studied this question.

synapsesocial.com/papers/6a7ff82acf96de1eb9c859behttps://doi.org/10.1186/s10194-025-02061-9
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Obesity-related Parameters as Potential Contributors to Increased Headache Frequency in Migraineurs2025
  2. 2Change in body mass index and disease burden among people with obesity and multiple long‐term conditions2026 · 2 citations
  3. 3Clinical and sociodemographic correlates of body mass index in a large multicenter obsessive–compulsive disorder sample2026
  4. 4Association of Obesity With Adverse Long-term Outcomes in Hypertrophic Cardiomyopathy2019 · 164 citations
  5. 5The Prevalence of Arrhythmias, Including Premature Supraventricular and Ventricular Beats and Other Electrocardiographic Patterns, in 24-Hour Holter Monitoring in Patients with Overweight and Obesity2024