Obesity and migraine are both highly prevalent disorders in the general 
population, influenced by genetic and environmental risk factors. In recent 
studies, obesity was found to be a strong risk factor for transformed migraine 
and, among migraineurs, obesity was associated with frequent headaches and 
higher disability scores. Suggested mechanisms included: (i) obesity as a 
pro-inflammatory state may be associated with neurovascular inflammation in 
patients with migraine; (ii) elevated levels of plasma calcitonin gene-related 
peptide (CGRP) in obese individuals may play a role as an important 
post-synaptic mediator of trigeminovascular inflammation in migraine; (iii) 
dismodulation in the hypothalamic neuropeptide, orexin, in obese persons may be 
associated with increased susceptibility to neurogenic inflammation causing 
migraine attacks; and (iv) leptin and adiponectin can activate proinflammatory 
cytokine release that is involved in the pathogenesis of migraine. In addition, 
both conditions are associated with psychiatric co-morbidities, such as 
depression and anxiety, that can further increase headache frequency and 
disability. Therefore, the effect of obesity on migraine outcome is important. 
Weight and BMI should be measured and calculated in all children presenting with 
migraine, and weight control should be a part of the treatment.