Medical Health Encyclopedia

People with diabetes are at higher risk for gallstones and have a higher than average risk for acalculous gallbladder disease (without stones). Gallbladder disease may progress more rapidly in patients with diabetes, who tend to suffer worse infections in general.

Obesity and Weight Changes

Obesity. Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated. Some evidence suggests that specific dietary factors (saturated fats and refined sugars) are the primary culprit in these cases, although studies are conflicting. Animal studies, however, suggest that obesity itself, not any particular foods, triggers the process leading to cholesterol supersaturation and the formation of stones.

Weight Cycling. Rapid weight loss or cycling (dieting and then putting back weight) further increases cholesterol production in the liver, with resulting supersaturation and risk for gallstones. A 2000 study suggested the following rates for gallstones related to extreme and rapid weight loss:

• The risk for gallstones is as high as 12% after eight to 16 weeks of restricted calorie diets.
• The risk is more than 30% within a year to 18 months after gastric by-pass surgery.

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About one-third of gallstone cases in these situations are symptomatic. The risk for gallstones is highest in the following dieters:

• Those who lose more than 24% of their initial body weight.
• Those who lose more than 1.5 kg (3.3. lb.) a week.
• Those on very low-fat, low-calorie diets.

Weight cycling also puts people at risk for gallstones. For example, a 16-year study found that the risk for gallstone surgery was 68% higher for women who lost and then regained more than 20 pounds at least once than in women whose weight remained stable.

Metabolic Syndrome