Weight Neutrality and Migraine

“Migraine is a complex neurological condition with a likely genetic component”

You can try to change your jean size all you want… but you can’t change your genes!

Are you constantly consumed with the number on the scale? Are you convinced that if you can just drop 10 pounds that your migraine is going to go away??? I am here with an unpopular healthcare opinion… your weight and BMI is NOT the cause of your migraine!

Migraine is a neurological condition with a likely genetic component. As a result, you were likely born with the predisposition for migraine. That means that despite the body size you are currently living in you would very likely still have migraine.

Standing up against diet culture is a hard thing to do, especially when your doctors support it (ever heard “just lose 10 pounds and your migraine will improve” or “let’s try gastric sleeve, that will cure your migraine”???). But did you know that the longest standing way to assess healthy body weight – BMI – is total BS??? Let’s get into it!

What is BMI?

BMI is a mathematical equation that was created by Adolphe Quetelet, a European sociologist, statistician, and mathematician. Do you notice he was NOT a healthcare professional??? Quetelet created the Body Mass Index (BMI) by calculating the average weight of a small group of European men in the 1800’s. Sound relevant to you in your body today? Probably not!

The calculation for BMI= kg/m2, or for the US- BMI= 703 x weight (lbs)/ height (in)2.

BMI chart

One thing to note is that BMI does not include variables for many populations. This formula does not include differences for men VS women, different ethnicities, body types, health conditions, or muscle mass.

According to this chart being underweight, overweight, or obese can put you at risk for certain health conditions including cardiovascular disease, diabetes, and cancer.

So a woman who is 5’4 and weighs 150 pounds that enjoys to power lift in her spare time is going to be considered overweight according to BMI, even though she prioritizes her health through nutrition and lifestyle. But if she loses just 6 pounds- that theoretical health risk completely goes away according to BMI! Does this make any sense to you????

Other ways to determine weight status

While BMI is used as the primary indicator to determine weight status (and it shouldn’t be!!), there are plenty of other ways to measure weight that are much more inclusive.

Dexa Machine: Uses X-ray to measure bone density and body composition including muscle mass, body fat, and water. Dexa is the gold standard for measuring body composition, but it’s extremely difficult to find access to this testing – and expensive!

Absolute Weight Circumference (Men= <40 inches, Women= <35 inches): The areas where you store fat can be an indication of possible health risks. Studies show that storing the majority of your fat in your abdomen can increase rates of cardiovascular disease (CVD), while storing weight in your lower half seems to pose little/no risk to heart health.

What can impact your migraine that is not your weight?

Now you know that BMI does not impact your migraine – it’s important to understand that nutrition and lifestyle choices play a much bigger role!

Nutrition deficiencies such as B12, vitamin D, iron, magnesium, and potassium can all make migraine worse and contribute to a lower threshold.

Symptoms of Nutrient Deficiences

What else can make a difference? Lifestyle and stress management!

Staying active can help raise your migraine threshold and has been shown to help reduce risks of disease and cancer. Aim for 20-30 minutes of exercise 5 days a week and focus incorporating strength training for 2 of those days.

And if you’re constantly stressing about the number on the scale, or are a chronic dieter- your body is going to be running off of stress hormones and your brain may think it is constantly in fight or flight. This is not good for your migraine threshold!

You have a RIGHT to decline to be weighed at the doctor’s office

Have you left your doctor’s feeling down on your body image after being weighed and told you needed to lose 20 pounds? Are you tired of your weight being the first (and only) thing discussed as a solution to migraine and other health problems?

As a patient, you have the RIGHT to decline to be weighed at your visits unless it is absolutely medically necessary. And guess what? You don’t even have to explain the reason why with these cards (not sponsored or an ad, these are something I frequently recommend because they’re awesome!!)

Don’t weigh me cards for healthcare visits
You do not have to justify why you don’t want to be weighed 💛

As a patient, you have the right to decline being weighed. If your nurse or doctor is persistent in you stepping on the scale, tell them to write in the medical notes “Patient declined to be weighed” and end the discussion.

The bottom line with weight and migraine…

In other words, your weight is simply not the reason you have migraine. There are SO MANY other factors that are much more important and that I care way more about as a dietitian! Stress, nutrient status, activity levels, and other factors like gut health and hormones all impact you so much more than the number on the scale.

I want to hear from you – are you having a difficult time with creating sustainable healthy habits that don’t involve your weight? Have you tried talking to your doctor about your concerns? Let me know in the comments.

Want more support managing migraine using a gentle, holistic approach? Click HERE to learn more about how I can help!

Medically Reviewed by Kelli Yates, RD, LD, CLT

Published by Kathryn Darsillo, B.S Nutrition & Dietetics, Dietetic Intern

Kathryn Darsillo, is currently a Dietetic Intern with Lenoir-Rhyne University and has a Bachelors of Science in Nutrition and Dietetics in addition to having an Associates Culinary Arts.

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