How does obesity increase the risk of gallstones? Scientific weight loss is key.

Gallstones

Gallstones refer to the formation of stones in any part of the gallbladder, intrahepatic or extrahepatic bile ducts. Based on their composition, gallstones are classified into cholesterol stones and pigment stones. Obesity is closely related to gallstone formation. Epidemiological studies show that obesity is a predisposing factor for cholesterol stones. The reasons why obese patients are prone to gallstones may include the following:

1. Cholesterol Supersaturation Due to High Cholesterol Secretion

The precipitation of solid cholesterol crystals from supersaturated bile is a necessary factor for the formation of cholesterol stones. When cholesterol concentration increases or bile salt and lecithin concentrations are relatively insufficient, cholesterol in the bile becomes supersaturated, and cholesterol crystals easily precipitate. In obese individuals, triglycerides and cholesterol levels in the blood are consistently elevated, leading to increased cholesterol secretion in the biliary system and causing cholesterol supersaturation.

2. High HMG-CoA Reductase Levels in Obese Individuals

Bile acids are an important preventative factor for both cholesterol stones and pigment stones. Cholesterol is a raw material for the synthesis of bile acids in the liver. The rate-limiting enzyme for bile acid synthesis is cholesterol-7α-hydroxylase, and the rate-limiting enzyme for cholesterol synthesis is HMG-CoA. In obese individuals, HMG-CoA reductase activity is increased while cholesterol-7α-hydroxylase activity is decreased, leading to bile supersaturation.

For the treatment of gallstones, obese patients and those with high blood lipids should appropriately restrict their fat intake. For biliary colic, jaundice, and other gastrointestinal symptoms caused by gallstones, symptomatic treatment should be given, and litholytic therapy may be necessary in some cases.