As more people try to lose weight quickly with anti-obesity injections, gallstone cases are also on the rise.
Gallstones are a condition in which bile components that help digest fat harden and turn stone-like, accumulating in the gallbladder or bile ducts and causing inflammation and pain. Experts warned that rapid weight loss can cause bile stasis and promote gallstone formation.
According to the Health Insurance Review & Assessment Service (HIRA) on the 4th, gallstone patients in Korea increased 103%, from 136,774 in 2015 to 277,988 in 2024. Patients undergoing cholecystectomy, the definitive treatment for gallstones, also rose 58% over the same period, from 57,553 to 91,172. Last year, 52% of those who had cholecystectomy were in their 30s to 50s.
Glucagon-like peptide (GLP)-1 receptor agonists, now widely used, help with weight loss by increasing satiety and delaying gastric emptying. Mounjaro by Eli Lilly and Company and Wegovy by the Danish corporations Novo Nordisk are representative. GLP-1 is a hormone secreted by the stomach or small intestine after eating and plays an important role in post-meal satiety, and these drugs mimic that mechanism.
However, there are concerns that the risk of gallbladder and biliary tract diseases may increase as weight drops rapidly. There are also study results related to this. According to research published in JAMA Internal Medicine, users of GLP-1 receptor agonists had a higher risk of gallbladder and biliary tract diseases than the control group, and in clinical trials for obesity treatment, the risk increased by about 2.3 times.
Gallstones are often asymptomatic, but after eating fatty foods, sudden pain may occur in the pit of the stomach or the upper right abdomen. It is easy to dismiss it as simple indigestion, but if the pain lasts for hours or is accompanied by fever, acute cholecystitis should be suspected.
Specialists said, "If gallstones are left untreated, cholecystitis can worsen or stones can migrate, leading to complications such as cholangitis and pancreatitis," and emphasized, "A safe pace takes priority over excessive weight loss."
Lee Kyung-joo, a professor in the Division of Gastroenterology at Hallym University Dongtan Sacred Heart Hospital, said, "If upper abdominal pain or discomfort recurs during rapid dieting, it is necessary to check for gallstones with an abdominal ultrasound," and added, "Even during obesity treatment, avoiding very low-calorie diets and reducing weight gradually in consultation with medical staff helps prevent gallstones."
References
JAMA Internal Medicine (2022) DOI: 10.1001/jamainternmed.2022.0338