The Link Between Gallstones, Obesity, and Weight Loss
Obesity increases your chances of developing gallstones, but so do weight loss surgery and certain types of diets. Find out how to safely reduce your risks.
Gallstones are rock-hard deposits that develop in the gallbladder, a small organ in the upper right abdomen just below the liver. Gallstones can be so small they’re barely visible, or as large as a golf ball. They can exist singly or by the hundreds. And they can be asymptomatic or excruciatingly painful.
Gallstones are formed when bile, which aids in the digestion of fat, contains too much cholesterol or bilirubin and not enough bile acids or lecithin (substances that allow water- and oil-based liquids to mix). Cholesterol gallstones are the most prevalent type, but stones made from bilirubin (called “pigment gallstones”) are also common.
Obesity can lead to gallstones because it “alters the balance of cholesterol versus lecithin versus bile acids in the gallbladder,” says William Silverman, MD, a gastroenterologist and emeritus professor of medicine at the University of Iowa Carver College of Medicine in Iowa City. Excess body weight also makes it more difficult for the gallbladder to empty, says Dr. Silverman, and this allows cholesterol-rich bile to accumulate and harden into stones.
How to Lose Weight Safely to Reduce Your Risk of Gallstones
Losing excess weight is a surefire way to reduce your risk of gallstones. Most experts agree that slow, steady weight loss is preferable to crash diets, which is especially important when it comes to gallstones. Rapid weight loss, meaning 3 or more pounds (lbs) per week, can trigger gallstones for the same reasons as obesity — it alters the balance of cholesterol, lecithin, and bile acids, and prevents the gallbladder from emptying adequately.
People who have had bariatric surgery are prime candidates for gallstones because they tend to lose a significant amount of weight in the first three to six months. The type of surgery doesn’t matter, says Silverman, because “it’s the weight loss that precipitates stones rather than the actual surgery.”
Gallstones are such a common occurrence after bariatric surgery that patients are routinely given ursodiol, a medication that helps prevent stone formation by decreasing cholesterol production and dissolving it in bile.
Weight loss of ½ to 2 lbs per week is a good goal for most people. Modest weight loss not only helps prevent gallstones, it also encourages new habits that can help put an end to losing and regaining weight repeatedly — and weight cycling is another risk factor for gallstones.
When it comes to gallstone prevention, the type of food you eat doesn’t really matter, says Silverman; the important thing is to avoid eating too much. That being said, extremely low-fat diets are not a great idea because they inhibit gallbladder contractions, making it harder for the gallbladder to empty and allowing bile to accumulate and calcify instead of being released into the small intestine.
Weight loss is best achieved with increased activity and a sustainable diet that doesn’t leave you feeling hungry, fatigued, or deprived. Consider working with a registered dietitian to develop a customized eating plan. And then try some of these weight loss tips that actually work to develop fad-resistant strategies that will help you achieve your goals:
Plan your meals in advance, especially when eating out. Menus are often posted online, which makes this a lot easier.
Keep a food journal. People who log everything they consume within 15 minutes of eating lose more weight than those who either don’t keep a journal or wait to record their entries.
Create a file (online or hard copy) of your favorite low-calorie recipes, and try to always have a stash of key ingredients in your fridge or cupboard.
Keep healthy, low-calorie snacks in your home, office, car, bag — wherever! This will help you stay on track when the munchies hit and the only thing around is junk food.
Identify and address “triggers” for unhealthy eating. This may be as simple as moving a candy dish off your coffee table or as challenging as getting to the bottom of why you eat when stressed or bored.
Eat only until you’re satisfied, not until you’re stuffed. If you eat slowly and mindfully, you’re less likely to overeat because it takes about 15 to 20 minutes for your brain to register that your stomach is full.
Try not to multitask while eating. Turn off the TV, power down your computer, and don’t take or make calls during meals. Talking to dining companions is perfectly fine, of course — you can’t (or shouldn’t) talk and eat at the same time, so a good conversation can help extend the mealtime and prevent overeating.
Make sure you get enough sleep. Sleep deprivation sets you up for weight gain by increasing hunger and decreasing your ability to resist comfort foods.
Finally, don’t expect to be perfect. Stuff happens, and you can’t always control what, where, and how you eat. The occasional extra piece of pizza or a couch potato day will not ruin your weight loss efforts or result in a spontaneous gallstone. Just try to learn from the experience so you can prevent it from happening again, and then get right back to your healthy eating and exercise plan.
Gallstones form when bile contains too much cholesterol or bilirubin and not enough bile acids, potentially causing significant discomfort. Losing weight steadily can lower your risk, while crash diets can lead to gallstone formation. Eating mindfully and planning your meals can help you lose weight in a healthy, sustainable way.
Sean Hashmi, MD, is an experienced nephrologist and obesity medicine specialist based in Southern California. As the regional director for clinical nutrition and weight management at a prominent healthcare organization in Southern California, Dr. Hashmi oversees the development and implementation of cutting-edge nutritional programs and weight management strategies. With his innovative approach and unwavering commitment to providing evidence-based solutions, he is a highly sought-after speaker and a leader in his field.
Hashmi founded the nonprofit organization SelfPrinciple.org to provide accessible and accurate health, nutrition, and wellness information to the public. Through this platform, he shares the latest research findings, empowering individuals to make informed decisions about their well-being. Self Principle also supports children's education by providing scholarships, books, and supplies, so that students have the resources necessary to succeed academically and build a brighter future.
Erica Ilton, RDN, CDN, is a registered dietitian nutritionist with a private practice in New York City. She is a Lead Dietitian at FODMAP Everyday, a website devoted to education and recipes related to the low FODMAP diet. She specializes in gastrointestinal disorders including irritable bowel syndrome (IBS), small intestinal bacterial overgrowth (SIBO), bloating and distention, constipation, lactose and other food intolerances, gastroparesis, gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD), celiac disease, and more.
Ilton previously worked as a clinical nutrition coordinator for the Department of Gastroenterology at Mount Sinai Hospital in New York, senior dietitian at Joy Bauer Nutrition, teaching assistant at Columbia University College of Physicians and Surgeons, and contributing producer for NPR's Science Friday and WNYC/New York Public Radio. She was a producer and consultant for YouTube's "What The Heck Are You Eating, With Joy Bauer."
Her health and nutrition articles have appeared on FODMAPeveryday.com, BerkeleyWellness.com, WellnessLetterOnline.com, and in Parade, Self, and Woman's Day magazines. She has edited two books on nutrition—Joy Bauer's Food Cures and the fourth edition of The Complete Idiot's Guide to Total Nutrition.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
