- New research shows that idiopathic intracranial hypertension (IIH) cases, a rare type of headache related to weight gain, are on the rise.
- While rare, IIH rates increased sixfold in Wales during a 15-year period.
- These headaches can cause general migraine symptoms and vision problems that can be permanent.
- While it’s unlikely that a given headache is IIH, anyone with persistent headaches, particularly when other symptoms accompany them, should seek a medical professional’s evaluation.
The side effects associated with obesity are well-documented.
They include higher blood pressure, heightened risk factors for various ailments, and increased mortality.
New research sounds the alarm on another ailment possibly associated with obesity: migraine headaches that can literally cause blindness.
A study conducted in Wales published recently in the journal Neurology found that rates of idiopathic intracranial hypertension (IIH) increased sixfold between 2003 and 2017.
Though the study examined an exclusively Welsh cohort, researchers say its lessons are applicable elsewhere — particularly in the United States, where
“[This study] underscores the need for losing weight,” Dr. Kuldeep Singh, director of the Bariatric Center at Mercy Hospital in Baltimore, told Healthline. “Although there can be many reasons for headaches in someone with obesity, one should have a proper doctor’s evaluation, especially if headaches persist more than a month or have associated vision changes.”
Though obesity and IIH may be linked, that doesn’t mean every headache under these conditions is necessarily a sign of IIH.
Dr. Howard R. Krauss, surgical neuro-ophthalmologist and clinical professor of ophthalmology and neurosurgery at John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, told Healthline that even with the recent increase, IIH remains rare.
He noted that these headaches are still less than 1/10 of 1 percent of the population.
“Readers with headaches should not rush to presume they have IIH,” he said. “Nonetheless, headaches should not be ignored, and those suffering with headaches are well-advised to seek medical evaluation.”
Krauss also noted that weight gain could exacerbate headache syndromes, but he said attention in people with IIH should be heightened because of the risk of vision damage.
Dr. Yuna Rapoport, an ophthalmologist and founder of Manhattan Eye, an ophthalmology practice in New York, explained how IIH could wreak havoc on the eyes.
“This study, while alarming, comes as no surprise to ophthalmologists,” she told Healthline. “We’ve been seeing repercussions from IIH for decades. IIH pushes on the optic nerve, and the optic nerve edges become blurred on the dilated exam. Typical visual findings include random blurry or dark spots, constricted vision, decreased contrast sensitivity, and decreased central vision. Other non-visual findings include a whooshing sound in the ears, headache, nausea, and vomiting.”
Persistent headaches should never be ignored, even if the cause being IIH is slim.
Singh says roughly 1/10 of his bariatric patients experience chronic headaches.
To get the best care and mitigate risk, the best-practice advice comes down to that age-old medical wisdom: Talk with your medical professional, Singh says.
“Timely intervention is everything,” he stressed.
Krauss recommends keeping a journal of headache triggers — for instance, stress, loss of sleep, or dehydration — to better understand and avoid the factors that can cause a headache.
“One should remember, however, that even those with migraine may develop other disorders leading to headache, so one should not self-diagnose and treat, but seek medical evaluation and management,” said Krauss.
Headaches related to obesity can be mitigated by simply adopting lifestyle changes.
Because that is easier said than done, other strategies could mitigate severe headache risks. Dr. Medhat Mikhael, a pain management specialist and medical director of the non-operative program at the Spine Health Center at MemorialCare Orange Coast Medical Center in California, told Healthline that some of the simpler ways to treat a headache include:
- avoiding stress
- finding new relaxation techniques
- avoiding triggers such as certain foods, alcohol, or caffeine
- getting exercising
- getting enough sleep
For more severe cases, Mikhael says some options include massage therapy and prescription medication.
“There are several options to treat headache, which include but are not limited to acupuncture, massage therapy, interventions like nerve blocks and trigger muscle injections,” he said. “Also, there are multiple therapeutic options to abort acute episodes of headache ranging from acetaminophen to non-steroidal, anti-inflammatories to the Triptan family for migraine, to the most recent CGRP inhibitors.”
However, for people with obesity/overweight, there’s one enduring piece of advice, not only for mitigating headaches but for all ailments.
“The recommendation beside all other interventions and treatment options is weight loss,” Mikhael said.
With the debilitating headaches and even blindspots of IIH, Krauss says many people still mitigate the risk factors.
“The very good news is that the vast majority of those who develop IIH in association with weight gain will go into long-term remission with a 15 percent weight loss, but one should not engage in self-diagnosis and treatment,” he said.
“Those with headaches, especially those with headaches and additional symptoms, such as alterations in vision, should seek medical evaluation and management. It should also be noted that many IIH patients in remission will relapse should they regain the weight,” Mikhael added.