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Gallstones and Morbid Obesity

Gallstones and Gallbladder Disease

Gallstones occur in about 1 in 10 people over 40 years of age. They are the commonest form of gallbladder disease. They are formed from bile which is mainly composed of cholesterol. Being seriously overweight or obese is a significant risk factor for gallstone development. A high-fat diet may also be a risk factor. In obese patients, especially those with morbid or malignant obesity, the liver produces excessive amounts of cholesterol causing bile to become highly saturated. Whether specific dietary factors (such as intake of saturated fat or high-GI food) or obesity per se is the primary cause for this, remains unclear.

Gallstones and Gallbladder Disease Among Obese and Morbidly Obese

The risk of gallstones is approximately 3 times greater for obese patients than in non-obese people. Indeed, the risk of sympomatic gallstones appears to correlate with a rise in body mass index (BMI). In a 1991 study of gallbladders routinely removed in the course of bariatric surgery to reduce morbid obesity, 6 out of 10 were found to have abnormalities.

Too-Rapid Weight Loss Also Increases Risk of Gallstones

Paradoxically, too-rapid weight loss also increases the risk of developing gallstones – one reason why bariatric surgeons sometimes remove the gallbladder during a gastric bypass operation. To avoid the likelihood of gallstone formation, aim for steady weight loss of about 2 pounds per week.

Weight Cycling Also Associated With Gallbladder Disease

Weight cycling – that is yo-yo dieting, involving the loss and regain of weight – also appears to lead to gallstone formation. However, clinical evidence for how weight cycling causes this gallbladder disorder is not conclusive.

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