[Healthy 100 Years] "Lose weight too fast and stones form"…gallstones have doubled in 10 years

 (Seoul=News1) Reporter Cho Yu-ri = Gallbladder disease is on the rise amid the spread of obesity drugs and a craze for rapid dieting. The faster weight falls, the more easily gallstones form, and the number of gallstone patients has in fact nearly doubled in ten years. Because the condition can progress without notable symptoms and then lead to sudden pain, day-to-day management is important.

Weight gain and rapid weight loss both raise 'gallstone' risk
According to the Health Insurance Review and Assessment Service on the 26th, the number of gallstone patients in Korea rose about 103%, from 136,774 in 2015 to 277,988 in 2024. Over the same period, patients undergoing cholecystectomy also increased 58%, from 57,553 to 91,172.

Gallstone disease is a condition in which stones form in the gallbladder. Located near the liver, the gallbladder stores bile produced by the liver and releases it when food arrives, helping to digest fat. If the balance of cholesterol and other components in the bile is disrupted, however, crystals form; as they gradually harden they turn into stone-like masses and cause inflammation of the gallbladder.

Changes in eating habits and lifestyle are cited as the main reasons for the rise in gallstone patients. As metabolic conditions such as obesity, diabetes and hyperlipidemia become more common, cholesterol concentrations in bile rise, and continued overeating or a high-calorie diet places a greater burden on the gallbladder.

Conversely, extreme dieting is also a risk factor. When weight drops sharply, the cholesterol excreted into the bile increases, while reduced food intake slows the movement of the gallbladder. In other words, bile becomes concentrated in the gallbladder, creating conditions in which gallstones form easily. Some reports indicate that gallstones developed in about 25% of people who went on severe diets.

Recently, more people have been using GLP-1 class weight-loss injections to lose weight rapidly over a short period, which is further increasing the risk of gallbladder disease. According to a study published in the international journal 'JAMA Internal Medicine', use of GLP-1 receptor agonists is associated with an increased risk of gallbladder and biliary tract disease. Experts consider that the main causes are rapid weight loss and reduced gallbladder motility rather than the drugs themselves.

“Gallstones are the most common cause of gallbladder inflammation”… and if they block the pancreatic duct, there is a risk of acute pancreatitis
Gallstones themselves often cause no symptoms; the problem arises when a stone blocks the cystic duct. Pressure inside the gallbladder rises, inflammation sets in, and this can progress to acute cholecystitis.

Park, Kwan Tae, Director at St. Peter's Hospital and a general surgery specialist, explained, “Gallstones are the most common cause of cholecystitis,” adding, “If the inflammation progresses, it can go beyond simple pain to cause tissue changes and loss of function.”

The situation becomes more serious if the stone moves further down and blocks the bile duct or the pancreatic duct. Blocked bile drainage can cause jaundice, and if the duct leading to the pancreas is obstructed it can progress to acute pancreatitis.

Symptoms vary by stage. Gallstone disease is often asymptomatic, but when the bile duct is blocked, a squeezing pain appears in the upper right abdomen or the pit of the stomach. If it progresses to acute cholecystitis the pain persists, accompanied by fever and vomiting. Chronic cholecystitis produces symptoms similar to digestive disease, such as abdominal discomfort and bloating, and is therefore easy to miss.

Diagnosis is made mainly by abdominal ultrasound, which can identify more than 90% of gallstones. Treatment depends on whether symptoms are present; when pain recurs or acute inflammation develops, surgery to remove the gallbladder is the standard treatment.

Director Park said, “If symptoms are mild, oral dissolution therapy using medication to dissolve the stones can be used, but it has the drawback that complete dissolution occurs in less than 30% of cases and about half recur after five years or more.”

He went on, “For chronic cholecystitis, the principle is that no specific treatment is given if there are no symptoms. However, since there is a long-term risk of progression to acute cholecystitis, once gallstones are found it is advisable to track changes with periodic abdominal ultrasound.”

Finally he stressed, “From the 40s onward in particular, metabolic function declines and the risk of gallstones and gallbladder disease rises, so if you have upper abdominal pain that feels different from usual, it is important not to brush it off but to get examined.”