How can I prevent gallstones while fasting for weight loss?

From the FDA Drug Label

The recommended dosage of Ursodiol for gallstone prevention in patients undergoing rapid weight loss is 600 mg/day (300 mg b.i.d.). Gallstone Prevention Two placebo-controlled, multicenter, double-blind, randomized, parallel group trials in a total of 1,316 obese patients were undertaken to evaluate Ursodiol in the prevention of gallstone formation in obese patients undergoing rapid weight loss

To prevent gallstones while fasting for weight loss, the recommended dose of Ursodiol is 600 mg/day (300 mg twice a day) 1. This dosage has been shown to be effective in preventing gallstone formation in obese patients undergoing rapid weight loss, with a significant reduction in the incidence of gallstone formation compared to placebo 1.

• The mean weight loss for the 16-week trial was 47 lb for the placebo group, and 47,48, and 50 lb for the 300,600, and 1200 mg/day Ursodiol groups, respectively.
• The mean weight loss for the 6-month trial was 64 lb for the placebo group, and 67,74, and 72 lb for the 300,600, and 1200 mg/day Ursodiol groups, respectively.
• Ursodiol is indicated for the prevention of gallstone formation in obese patients experiencing rapid weight loss 1.

From the Research

To prevent gallstones while fasting for weight loss, it is crucial to avoid rapid weight loss and consider taking ursodeoxycholic acid (ursodiol) at 300-600mg daily, as supported by the most recent and highest quality study 2. When attempting to lose weight through fasting, several key strategies can help minimize the risk of developing gallstones.

• Avoid rapid weight loss of more than 3-4 pounds per week, as this can increase the concentration of cholesterol in bile and reduce gallbladder contractions, creating ideal conditions for stone formation 3.
• Instead, aim for gradual weight loss of 1-2 pounds weekly by implementing intermittent fasting rather than extended fasts.
• Stay well-hydrated by drinking at least 8-10 glasses of water daily, as dehydration concentrates bile and increases stone risk.
• Include healthy fats in your eating windows, such as olive oil, avocados, and nuts, which help stimulate gallbladder contractions and prevent bile stagnation 4.
• Consider taking ursodeoxycholic acid (ursodiol) at 300-600mg daily during your weight loss period if you have additional risk factors or previous gallstone history, though this requires a prescription, as it has been shown to reduce the risk of gallstone formation 5.
• Consume adequate fiber (25-30g daily) during eating periods to help regulate cholesterol metabolism. If you experience right upper abdominal pain, nausea, or vomiting during your fasting program, seek medical attention immediately, as these could be symptoms of gallstones. The use of ursodeoxycholic acid in preventing gallstones during weight loss is supported by recent studies, including a meta-analysis that demonstrated its effectiveness in reducing the risk of gallstone formation 5, and a more recent review that highlights the need for further research but also acknowledges the potential benefits of UDCA in symptomatic gallstone disease 2.