From the Guidelines
Gallstones themselves do not directly inhibit weight loss, but they can indirectly affect weight loss efforts by causing symptoms like pain, nausea, and digestive discomfort. These symptoms might limit food choices or reduce physical activity, making it more challenging to lose weight 1. Some people with gallstones may avoid certain healthy fats that could trigger gallbladder attacks, potentially making dietary changes for weight loss more difficult. Additionally, rapid weight loss (losing more than 3-5 pounds per week) can actually increase the risk of developing gallstones because quick weight reduction can cause the liver to secrete extra cholesterol into bile, promoting stone formation.
Key Considerations for Weight Loss with Gallstones
- Aim for gradual weight loss of 1-2 pounds per week to minimize the risk of developing gallstones or exacerbating existing ones.
- Stay well-hydrated and eat regular meals with adequate fiber to help manage symptoms and support overall health.
- Include some healthy fats in your diet, but be mindful of portion sizes and potential triggers for gallbladder attacks.
- If you experience severe pain, fever, or jaundice with your gallstones, seek medical attention as these symptoms may indicate complications requiring treatment.
Treatment Options for Gallstones
- Expectant management may be recommended for patients with asymptomatic gallstones, as the risks of surgical and nonsurgical intervention may outweigh their benefits 1.
- For symptomatic gallstones, treatment options may include medications like ursodiol, surgical removal of the gallbladder (cholecystectomy), or other interventions.
- The choice of treatment will depend on individual factors, including the severity of symptoms, overall health, and personal preferences.
From the FDA Drug Label
The first trial consisted of 1,004 obese patients with a body mass index (BMI) ≥ 38 who underwent weight loss induced by means of a very low calorie diet for a period of 16 weeks An intent-to-treat analysis of this trial showed that gallstone formation occurred in 23% of the placebo group, while those patients on 300,600, or 1200 mg/day of Ursodiol experienced a 6%, 3%, and 2% incidence of gallstone formation, respectively The mean weight loss for this 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.
Gallstones can inhibit weight loss is not directly supported by the text, however, the text does suggest that rapid weight loss can increase the risk of gallstone formation.
- The studies show that gallstone formation occurred in 23% of the placebo group, indicating a significant risk of gallstone formation during rapid weight loss.
- The use of Ursodiol reduced the incidence of gallstone formation, but did not address whether existing gallstones can inhibit weight loss. 2
From the Research
Gallstone Formation and Weight Loss
- Gallstones can form during weight loss, especially with very-low-calorie diets 3
- The incidence of gallstone formation is dependent on the degree of caloric restriction, the rate of weight loss, and the duration of the dietary intervention 3
- Faster rates of weight loss for longer periods of time are associated with increased risk of gallstone formation 3
Effect of Gallstones on Weight Loss
- There is no direct evidence that gallstones inhibit weight loss, but gallstone formation can be a complication of rapid weight loss 3, 4, 5
- Ursodeoxycholic acid (ursodiol) has been shown to be effective in preventing gallstone formation after bariatric surgery 4, 5
- Ursodiol can dissolve small, primarily cholesterol gallstones, but its effectiveness depends on the size and number of stones, as well as the functional status of the gallbladder 6, 7
Prevention of Gallstone Formation
- Ursodiol can prevent gallstone formation after bariatric surgery, with a significant reduction in gallstone formation compared to placebo 5
- Prophylactic ursodiol can be prescribed to patients without gallstones after laparoscopic gastric bypass to prevent gallstone formation 4
- Intraoperative ultrasound screening can efficiently screen for gallstones during laparoscopic gastric bypass, and selective cholecystectomy followed by prophylactic ursodiol can result in low morbidity 4