Medications known as GLP 1 receptor agonists, commonly prescribed for weight loss and diabetes, have gained enormous popularity in recent years. While these medications can be highly effective in helping patients lose weight, physicians are also paying close attention to potential side effects, including an increased risk of gallstones.
According to Lisa Iucci, DO, FACS, of Premier Surgical Network in Egg Harbor Township, NJ the connection between rapid weight loss and gallbladder problems has been known for years. Similar patterns were observed decades ago with bariatric, or weight loss, surgery.
“When patients lose weight quickly, the body processes and eliminates cholesterol more rapidly,” Dr. Iucci explains. “That cholesterol can concentrate in bile, which is stored in the gallbladder. Over time it can crystallize and form gallstones.”
Gallstones are small, hardened deposits that most commonly develop from cholesterol. Some people may have gallstones without ever experiencing symptoms. For others, they can trigger painful episodes known as gallbladder attacks.
The gallbladder sits beneath the liver on the right side of the abdomen. Its role is to store bile, a digestive fluid that helps break down fats. When a person eats a fatty meal, the body signals the gallbladder to contract and release bile into the first portion of the small intestine, called the duodenum, where digestion continues.
“If gallstones are present, that squeezing motion can press against the stones,” says Dr. Iucci. “That is what causes the pain people feel during an attack.”
Symptoms often include sharp or cramping pain beneath the right rib cage, what physicians call the right upper quadrant of the abdomen. The discomfort may last for several hours before resolving. However, repeated attacks or complications can signal a more serious problem.
In some cases, a small gallstone can become lodged in the duct that drains bile from the gallbladder. When this happens, bile can no longer flow normally, potentially leading to inflammation or infection of the gallbladder, a condition called acute cholecystitis. Patients may experience persistent pain, fever, nausea, and abnormal blood tests. At that point, surgical removal of the gallbladder is often necessary.
Dr. Iucci emphasizes that the risk is not limited to GLP 1 medications alone. Any situation involving rapid weight change, such as pregnancy or significant dietary weight loss, can increase the likelihood of gallstone formation.
Because of this, proper medical supervision is critical when using GLP 1 medications. Some specialists recommend evaluating the gallbladder before starting treatment, particularly in patients who may already have stones. In certain cases, physicians may prescribe medications such as ursodiol to help prevent stone formation, although these medications are not always well tolerated.
“The most important thing is that patients are being followed by someone experienced with these medications,” Dr. Iucci says. “GLP 1 drugs affect multiple systems in the body, so it is important to monitor patients carefully.”
She cautions against obtaining weight loss medications through online sources or taking prescriptions intended for someone else.
“Any medication should be prescribed and monitored by a qualified physician,” she says. “That way, if complications arise, they can be detected and treated early.”
For patients considering GLP 1 therapy, the takeaway is simple, these medications can be valuable tools for weight management, but they should always be used as part of a medically supervised plan that prioritizes safety as well as results.
