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The Role of Gallbladder Emptying in Gallstone Formation During Diet–Induced Rapid Weight Loss
Abstract
Obese persons are at risk for cholesterol gallstones because their bile is saturated with cholesterol. The risk increases during rapid weight loss by means of certain very–low–calorie diets or gastric bypass surgery. Gallstone risk factors during rapid weight loss include increased bile cholesterol saturation index and gallbladder stasis. Obese subjects were randomized to one of two low–calorie liquid diets for rapid weight loss: a 520–kcal diet with less than 2 g fat/d, and a 900–kcal diet with 30 g fat/d (including one 10–g fat meal to stimulate maximal gallbladder emptying). Bile and blood lipids, saturation index, leukocyte 3–hydroxy–3–methylglutaryl coenzyme A (HMG CoA) reductase activity, and ultrasonographic gallbladder emptying were measured repeatedly during dietary treatment. Both diets produced comparable weight loss of 22%. Bile cholesterol saturation index increased during both diets (26%), but fell to 15% below prediet level after weight loss. Compared with subjects' maximal gallbladder emptying fraction of 66%, the 520–kcal diet provided poor gallbladder emptying (35%), whereas the 10–g fat meal of the 900–kcal diet provided maximal emptying. Gallstones developed in four of six 520–kcal subjects and none of seven 900–kcal subjects ( P = .021), an unanticipated difference that resulted in premature study termination for ethical reasons. Blood lipids and HMG CoA reductase activity in mononuclear leukocytes fell at week 8 during both diets, but recovered while weight was still being lost. The findings suggest that gallstone risk during rapid weight loss may be reduced by maintenance of gallbladder emptying with a small amount of dietary fat. Ultimately, weight loss reduced bile cholesterol saturation and improved highdensity lipoprotein (HDL) levels.
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Weight cycling is an independent risk factor for gallstones.
“Weight cycling (i.e., weight that is lost and regained) is an independent risk factor for gallstones [34][35][36].”
From Excess Body Weight and Gallstone Disease (2021) · cites this paper as [34]
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Metadata
- Authors
- Gebhard, R. L., Prigge, W. F., Ansel, H. J., Schlasner, L., Ketover, S. R., Sande, D., Holtmeier, K., & Peterson, F. J.
- Affiliations
- Minneapolis VA Medical Center (US)
- ORCID
- Ansel, H J
- Venue
- Hepatology
- Published
- 1996-09
- Volume
- 24
- Issue
- 3
- Pages
- 544-548
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2020577433
- Cited by
- 113
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 11 · 2021: 5 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 6 · 2015: 4 · 2014: 7 · 2013: 3 · 2012: 3
- FWCI
- 2.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gallbladder and Bile Duct Disorders
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
- Keywords
- gallstone formation, gallbladder emptying, rapid weight loss, very low calorie diet, cholesterol gallstones, gallbladder stasis, dietary fat, leukocytes, serum lipids, HDL cholesterol, obesity, gastric bypass
- MeSH terms
- Adult, Cholelithiasis, Diet, Reducing, Dietary Fats, Female, Humans, Male, Middle Aged, Obesity, Reference Values, Time Factors, Weight Loss, Gallbladder Emptying
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