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Do patients with migraine and obesity receive different treatments? Insights from real‐world data.

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Title: Do patients with migraine and obesity receive different treatments? Insights from real‐world data.
Authors: Pardo, Keshet (AUTHOR), Mermelstein, Maor (AUTHOR), Tsur, Gal (AUTHOR), Yust‐Katz, Shlomit (AUTHOR)
Source: Headache: The Journal of Head & Face Pain. Jan2026, Vol. 66 Issue 1, p88-95. 8p.
Subjects: Migraine prevention, Prevention of obesity, Databases, Risk assessment, Chronic pain, Medical prescriptions, Body mass index, Topiramate, Medical care, Probability theory, Multiple regression analysis, Retrospective studies, Duloxetine, Descriptive statistics, Chi-squared test, Mann Whitney U Test, Cardiovascular diseases risk factors, Longitudinal method, Amitriptyline, Odds ratio, Pain management, Opioid analgesics, Medical records, Acquisition of data, Statistics, Nonopioid analgesics, Comparative studies, Data analysis software, Confidence intervals, Migraine, Obesity, Social stigma, Comorbidity, Sympatholytic agents
Geographic Terms: Israel
Abstract: Background: Patients with obesity often experience stigma in healthcare, which may lead to underdiagnosis or undertreatment. In the context of pain management, and migraine specifically, patients with obesity are more likely to receive both opioid and non‐opioid analgesics. However, little is known about their use of preventive treatments. Methods: We conducted a large retrospective cohort study using propensity score matching for sex and age, utilizing data from the Clalit Health Services database in Israel. The study compared newly diagnosed patients with migraine with and without obesity, identified between June 2020 and June 2023. The comparison focused on prescriptions for migraine‐specific acute medication (triptans) and preventive migraine treatments. Results: Our final analysis included 11,934 patients with migraine and obesity and 11,934 without obesity. Patients with obesity were more likely to have cardiovascular risk factors and psychiatric comorbidities. Patients with obesity were also more likely to receive acute treatment with triptans (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] [1.11–1.23]), and preventive treatments such as topiramate (aOR 1.66, 95% CI [1.38–1.99]), gabapentinoids (aOR 1.30, 95% CI [1.13–1.50]), and duloxetine (aOR 1.42, 95% CI [1.18–1.70]), adjusting for comorbidities. Conclusion: Our findings do not support the notion that patient with migraine and obesity are undertreated; instead, they show a modest increase in prescriptions for acute and some of the preventive medications. Plain Language Summary: Patients with obesity often experience stigma in healthcare, which may lead to underdiagnosis and undertreatment. In the fields of pain and headache, patients with obesity are more likely to receive both opioid and non‐opioid analgesics, raising the question of whether they receive adequate preventive treatment. In our large‐scale study based on an analysis of a health services database in Israel, patients with migraine and obesity were not undertreated with preventative treatment and actually had a modest increase in prescriptions for both migraine‐specific acute treatment and some of the preventive treatments. [ABSTRACT FROM AUTHOR]
Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
FullText Text:
  Availability: 0
Header DbId: pbh
DbLabel: Psychology and Behavioral Sciences Collection
An: 191181537
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
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  Label: Title
  Group: Ti
  Data: Do patients with migraine and obesity receive different treatments? Insights from real‐world data.
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  Data: <searchLink fieldCode="AR" term="%22Pardo%2C+Keshet%22">Pardo, Keshet</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mermelstein%2C+Maor%22">Mermelstein, Maor</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tsur%2C+Gal%22">Tsur, Gal</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yust‐Katz%2C+Shlomit%22">Yust‐Katz, Shlomit</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Headache%3A+The+Journal+of+Head+%26+Face+Pain%22">Headache: The Journal of Head & Face Pain</searchLink>. Jan2026, Vol. 66 Issue 1, p88-95. 8p.
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  Data: <searchLink fieldCode="DE" term="%22Migraine+prevention%22">Migraine prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Prevention+of+obesity%22">Prevention of obesity</searchLink><br /><searchLink fieldCode="DE" term="%22Databases%22">Databases</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+pain%22">Chronic pain</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+prescriptions%22">Medical prescriptions</searchLink><br /><searchLink fieldCode="DE" term="%22Body+mass+index%22">Body mass index</searchLink><br /><searchLink fieldCode="DE" term="%22Topiramate%22">Topiramate</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Probability+theory%22">Probability theory</searchLink><br /><searchLink fieldCode="DE" term="%22Multiple+regression+analysis%22">Multiple regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Duloxetine%22">Duloxetine</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Chi-squared+test%22">Chi-squared test</searchLink><br /><searchLink fieldCode="DE" term="%22Mann+Whitney+U+Test%22">Mann Whitney U Test</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiovascular+diseases+risk+factors%22">Cardiovascular diseases risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Amitriptyline%22">Amitriptyline</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+management%22">Pain management</searchLink><br /><searchLink fieldCode="DE" term="%22Opioid+analgesics%22">Opioid analgesics</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+records%22">Medical records</searchLink><br /><searchLink fieldCode="DE" term="%22Acquisition+of+data%22">Acquisition of data</searchLink><br /><searchLink fieldCode="DE" term="%22Statistics%22">Statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Nonopioid+analgesics%22">Nonopioid analgesics</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Migraine%22">Migraine</searchLink><br /><searchLink fieldCode="DE" term="%22Obesity%22">Obesity</searchLink><br /><searchLink fieldCode="DE" term="%22Social+stigma%22">Social stigma</searchLink><br /><searchLink fieldCode="DE" term="%22Comorbidity%22">Comorbidity</searchLink><br /><searchLink fieldCode="DE" term="%22Sympatholytic+agents%22">Sympatholytic agents</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Israel%22">Israel</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Patients with obesity often experience stigma in healthcare, which may lead to underdiagnosis or undertreatment. In the context of pain management, and migraine specifically, patients with obesity are more likely to receive both opioid and non‐opioid analgesics. However, little is known about their use of preventive treatments. Methods: We conducted a large retrospective cohort study using propensity score matching for sex and age, utilizing data from the Clalit Health Services database in Israel. The study compared newly diagnosed patients with migraine with and without obesity, identified between June 2020 and June 2023. The comparison focused on prescriptions for migraine‐specific acute medication (triptans) and preventive migraine treatments. Results: Our final analysis included 11,934 patients with migraine and obesity and 11,934 without obesity. Patients with obesity were more likely to have cardiovascular risk factors and psychiatric comorbidities. Patients with obesity were also more likely to receive acute treatment with triptans (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] [1.11–1.23]), and preventive treatments such as topiramate (aOR 1.66, 95% CI [1.38–1.99]), gabapentinoids (aOR 1.30, 95% CI [1.13–1.50]), and duloxetine (aOR 1.42, 95% CI [1.18–1.70]), adjusting for comorbidities. Conclusion: Our findings do not support the notion that patient with migraine and obesity are undertreated; instead, they show a modest increase in prescriptions for acute and some of the preventive medications. Plain Language Summary: Patients with obesity often experience stigma in healthcare, which may lead to underdiagnosis and undertreatment. In the fields of pain and headache, patients with obesity are more likely to receive both opioid and non‐opioid analgesics, raising the question of whether they receive adequate preventive treatment. In our large‐scale study based on an analysis of a health services database in Israel, patients with migraine and obesity were not undertreated with preventative treatment and actually had a modest increase in prescriptions for both migraine‐specific acute treatment and some of the preventive treatments. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Headache: The Journal of Head & Face Pain is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=191181537
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/head.70011
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 8
        StartPage: 88
    Subjects:
      – SubjectFull: Migraine prevention
        Type: general
      – SubjectFull: Prevention of obesity
        Type: general
      – SubjectFull: Databases
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Chronic pain
        Type: general
      – SubjectFull: Medical prescriptions
        Type: general
      – SubjectFull: Body mass index
        Type: general
      – SubjectFull: Topiramate
        Type: general
      – SubjectFull: Medical care
        Type: general
      – SubjectFull: Probability theory
        Type: general
      – SubjectFull: Multiple regression analysis
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Duloxetine
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Mann Whitney U Test
        Type: general
      – SubjectFull: Cardiovascular diseases risk factors
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Amitriptyline
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Pain management
        Type: general
      – SubjectFull: Opioid analgesics
        Type: general
      – SubjectFull: Medical records
        Type: general
      – SubjectFull: Acquisition of data
        Type: general
      – SubjectFull: Statistics
        Type: general
      – SubjectFull: Nonopioid analgesics
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Migraine
        Type: general
      – SubjectFull: Obesity
        Type: general
      – SubjectFull: Social stigma
        Type: general
      – SubjectFull: Comorbidity
        Type: general
      – SubjectFull: Sympatholytic agents
        Type: general
      – SubjectFull: Israel
        Type: general
    Titles:
      – TitleFull: Do patients with migraine and obesity receive different treatments? Insights from real‐world data.
        Type: main
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            NameFull: Pardo, Keshet
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            NameFull: Mermelstein, Maor
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            NameFull: Tsur, Gal
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            – D: 01
              M: 01
              Text: Jan2026
              Type: published
              Y: 2026
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            – TitleFull: Headache: The Journal of Head & Face Pain
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