NATIONAL HARBOR, Md. – Although many factors contribute to migraine, clinicians who treat these patients may want to take a closer look at another possible contributing condition — obesity.

B. Lee Peterlin, DO, associate professor of neurology and director of Johns Hopkins Headache Research in Baltimore, Maryland, reviewed migraines, obesity classification, and epidemiology at the American Academy of Pain Management 2015 meeting.

Migraines are often difficult to diagnosis because clinicians must rely heavily on patient-reported symptoms. “We don’t have any fancy tests,” said Dr. Peterlin.

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The International Classification of Headache Disorder-II  (ICHD-II) definition of migraine specifies the following  criteria for diagnosis:

A. At least 5 attacks fulfilling criteria B-D

B. A headache lasting 4 to 72 hours

C. Two of the following: unilateral; moderate or severe in nature; aggravated by routine activity; pulsating

D. One of the following: nausea and/or vomiting; photo and phonophobia

E. Symptoms unable to be attributed to another disorder1

Several demographic factors — female sex, white race, reproductive age, low socioeconomic status — predispose individuals to migraine, according to Peterlin. She also identified several potentially modifiable migraine triggers including obesity, fasting, lack of exercise, stressful life events, and sleep disorders.2

This article originally appeared on Clinical Pain Advisor