Gallstone Warning as 'Injectable Obesity Drugs' Spread... Number of Patients Doubled in 10 Years

Kyungjoo Lee, Professor at Hallym University Dongtan Sacred Heart Hospital:
"Rapid weight loss induces bile stasis, increasing the risk of gallstone disease"
Gallbladder disease risk up to 2.3 times higher with use of GLP-1 class obesity medicat

Recently, as glucagon-like peptide-1 (GLP-1) based obesity treatment injections have become more widespread, concerns have been raised about an increased risk of gallstones due to rapid weight loss. In fact, the number of gallstone patients in Korea has more than doubled over the past ten years.

Gyeongju Lee, Professor of Gastroenterology, Hallym University Dongtan Sacred Heart Hospital. Hallym University Dongtan Sacred Heart Hospital

According to the Health Insurance Review & Assessment Service on March 4, the number of domestic gallstone patients rose by 103%, from 136,774 in 2015 to 277,988 in 2024. During the same period, the number of patients undergoing cholecystectomy increased by 58%, from 57,553 to 91,172. Notably, in 2024, 52% of cholecystectomy patients were in their 30s to 50s, indicating that gallbladder surgeries are not uncommon among the economically active population.

Gallstone disease occurs when substances such as cholesterol in bile crystallize and harden into stone-like deposits within the gallbladder. When bile remains stagnant for extended periods, gallstones are more likely to develop.

Rapid weight loss is considered a primary factor that triggers such bile stasis. As body weight decreases quickly, the amount of cholesterol secreted from the liver into bile increases. At the same time, reduced food intake leads to less gallbladder contraction, causing bile to remain longer in the organ. During this process, bile becomes concentrated, which raises the risk of gallstone formation.

The widely used GLP-1 receptor agonists are drugs that suppress appetite and delay gastric emptying, thereby inducing weight loss. However, research has shown that if weight reduction occurs too quickly, the risk of gallbladder disease may increase.

A recent study published in the international journal 'JAMA Internal Medicine' found that the use of GLP-1 receptor agonists is linked to a higher risk of gallbladder and biliary tract diseases. In particular, clinical trials targeting weight loss showed that the risk of gallbladder and biliary tract diseases was about 2.3 times higher than in control groups.

Gallstone disease often presents no symptoms, but after eating fatty foods, sudden pain can occur in the upper abdomen or right upper quadrant. It is easy to mistake this for simple indigestion. However, if the pain lasts for several hours or is accompanied by fever, acute cholecystitis should be suspected.

Acute cholecystitis occurs when a gallstone blocks the cystic duct, preventing proper bile drainage. It often presents with both pain and fever. Initial treatment includes fasting and intravenous fluids, and antibiotics may be administered if necessary. Subsequently, cholecystectomy is performed as the standard treatment.

Kyungjoo Lee, Professor of Gastroenterology at Hallym University Dongtan Sacred Heart Hospital, said, "If you repeatedly experience upper abdominal pain or discomfort during rapid dieting, it is important to check for gallstones with an abdominal ultrasound." He added, "Even during obesity treatment, avoiding excessive short-term weight loss or extremely low-calorie diets and working with medical professionals to develop a gradual weight loss plan can help maintain gallbladder health."

This content was produced with the assistance of AI translation services.