"The Weight Is Down, but the Gallbladder Is Struggling"...The Dilemma of Obesity Injections [Health Talk]

[Financial News] It is easy to think of acute pancreatitis as a side effect of obesity injections such as Wegovy and Mounjaro. However, gallstone disease and cholecystitis also warrant attention.
Kim Kwang-hyun, chief of surgery at Incheon Sejong Hospital, explained, "Rapid weight loss itself is a major risk factor for gallstones. This does not mean that people should avoid obesity treatment. Rather, they should distinguish between abdominal discomfort caused by obesity injections and abdominal pain caused by gallstones or other conditions, and promptly visit a hospital for treatment."
Acute pancreatitis is the most commonly cited serious side effect of obesity injections. In recent years, however, gallstone disease and cholecystitis have also drawn attention as potential side effects.
A meta-analysis published in 2022 in JAMA Internal Medicine, a journal of the American Medical Association (AMA), found that patients who used glucagon-like peptide-1 (GLP-1) receptor agonists, a key class of obesity-injection drugs, had a 37% higher risk of gallbladder and biliary tract disease than those who did not use them.
The risk of undergoing cholecystectomy was also 70% higher. In studies involving the drugs for weight loss, the risk of gallbladder and biliary tract disease increased 2.29-fold. The study analyzed 76 randomized clinical trials involving more than 103,000 people.
Kim explained, "Rapid weight loss itself is a major risk factor for gallstones, and the study suggests that GLP-1 may also reduce gallbladder motility and bile flow. Rapid weight loss and bile stasis in the gallbladder may work together to create an environment conducive to gallstone formation." He added, "This does not mean that people should avoid effective obesity treatment because they are concerned about gallstones. The key is to avoid dismissing symptoms as merely a medication side effect and letting them go untreated."
Wegovy and Mounjaro can cause nausea or abdominal discomfort, making it difficult to distinguish the early symptoms of gallstones. If pain in the upper abdomen or right upper quadrant, or pain after meals, recurs—or if fever or jaundice occurs along with abdominal pain—patients should be evaluated for gallstone disease or cholecystitis.
If biliary colic or acute cholecystitis develops, simply stopping the obesity injection will not resolve the problem. That is because existing gallstones do not disappear on their own.
Kim said, "As obesity treatments rapidly become more widespread, pancreatitis is not the only cause of abdominal pain we need to watch for. In the era of obesity injections, we must also remember gallstone disease and cholecystitis. If symptoms occur, patients should promptly visit a medical institution and consult a specialist about definitive treatment options, such as medication or cholecystectomy."
 
[email protected] Medical Specialist Jung Myung-jin Reporter