Does dieting or weight loss cause gallstones or gallbladder disease?

Gallstones are clumps of solid material, mostly cholesterol, that form in the gallbladder, a small pear-shaped organ located under the liver in the abdomen. The gallbladder contracts and releases bile, a fluid made in the liver that aids in digestion. Bile contains substances called bile salts that help break down fats in the food we eat. Bile also helps eliminate cholesterol from the body via the digestive system.

It is known that simply being overweight is associated with a much higher risk for the development of gall bladder disease and gallstones than exists for the non-overweight population. Overweight or obese individuals may have three to five times the risk for developing gallstones as is seen in normal weight individuals. However, research has indicated that after losing weight, the risk for gallstone formation in the post-obese state appears to be no different from that seen in non-obese individuals.

Research studies suggest that there may be a small, temporary increased risk for the development of gallstones in overweight or obese individuals during weight loss. This appears to be related to the absence of a small but necessary amount of fat and/or protein in the diet over a long period of time, to allow for gallbladder contraction. Going for long periods of without eating (fasting), as some dieters do, decreases gallbladder contraction and increases the risk for gallstone formation.

Researchers believe that dieting causes an imbalance of bile salts and cholesterol in the gallbladder. The level of bile salts decreases, while cholesterol levels increase. Additionally, going for long periods without eating, as dieters often do, decreases gallbladder contraction, resulting in the formation of gallstones as the bile is not able to be released.

Cycles of dieting and weight gain increase one’s risk of painful gallstones and gallbladder surgery, reports a recent study published in the Annals of Internal Medicine. Of the 47,000 female nurses involved in the study, those who had at least one weight swing of 10 to 19 pounds had a 31% greater likelihood of undergoing removal of their gall bladder than women whose weight had remained stable. Those who had experienced at least one 20 pound or greater weight swing had a 68% greater likelihood of needing the operation. Obesity remains one of the strongest risk factors for gallstones.

Why do some people develop gallstones while others don’t? According to Italian researchers, one reason might be the amount of refined sugar they eat. According to Tufts University, a preliminary study conducted in southern Italy found that people who ate 400 calories or more of refined sugar each day were three times more likely to suffer from gallstones as those who ate no more than 260 calories of the sweet stuff a day. Those who consumed at least 600 calories from sugar were six times more likely to develop gallstones.

Refined sugars are contained in foods such as cakes, cookies, soft drinks, and table sugar. Thirty-two ounces of cola contain 400 calories from sugar, the equivalent of 12.5 teaspoons of sugar.

This same study also confirmed the relationship between excess weight and gallstone risk reported by other researchers, and it reported that both saturated fat and total caloric intake were linked to the tendency to develop gallstones.

Although it is too soon to say whether excessive amounts of sugar actually cause gallstone formation, keeping your sugar intake under control is certainly a good idea. And this study provides one more good reason to keep your weight and intake of saturated fats in line as well.

Following a weight reduction program that provides adequate amounts of protein and some fat may reduce the risk of developing gallstones.

Since weight reduction can greatly improve health and reduce the risk of obesity related disease, disability and death, individuals should make an informed decision concerning the health benefits of weight reduction versus the potential risk for the formation of gallstones in obese individuals who undergo weight reduction. If you have a history that suggests gallbladder disease (attack of sharp right upper abdominal pain with nausea, gas and bloating after eating, etc.) you should discuss this situation with your physician before beginning any weight loss program.