Eating disorders and headache: coincidence or consequence?

The eating disorders (ED) anorexia nervosa (AN) and bulimia nervosa (BN) are important psychiatric and somatic conditions occurring mainly in young women. The aetiology is unknown, but there are social, biological and psychological factors that play a relevant role in the pathogenesis, along with multiple endocrine abnormalities. Hypothalamic monoamines (especially serotonin), neuropeptides (especially neuropeptide Y and cholecystokinin) and leptin are involved in the regulation of the human appetite. ED share with migraine the same metabolic profile and aspect of psychiatric and psychological conditions. In support of this hypothesis in one study, it has been shown that the incidence of migraine is high in these patients; and it has been shown that the incidence in a female group that suffers from migraine was greater than in the normal population. In order to understand the possible relationship between migraine and ED, we have investigated the incidence of primary headache in a group of AN and BN patients. The result of this study shows that the prevalence of migraine in women affected by AN and BN is very high (75%) in comparison to the general population (12.5% headache incidence in normal population). In most patients the onset of migraine attacks began before or at the same time as the symptoms of AN and BN. We suggest that migraine is a predisposing condition for the occurence of AD in young women.