New Delhi: Gallstones are a very common issue related to digestive health. However, the risk of developing gallstones is higher in individuals with obesity. Although it may happen in any individual, the occurrence of obesity alters many metabolic functions in the body. The changed conditions in the body provide an ideal platform for the development of gallstones.
In an interaction with News9Live, Dr. Mriganka S. Sharma (Director-General & Minimally Invasive Surgery) & Dr. Amit D. Goswami (Associate Director-General & Minimally Invasive Surgery), CK Birla Hospital, Gurugram, decoded the gallstone-obesity link.
Comprehending Gallstones and Their Formation
Gallstones are hardened lumps that develop in the gallbladder. The gallbladder is a small organ that stores a fluid called bile. Bile is a substance that helps to break down fats in the body. If the chemical makeup of the substance is affected in any way, it becomes hardened and turns into gallstones. Gallstones are largely composed of cholesterol. They are directly associated with the body’s processing of fats and cholesterol.
- Excess Cholesterol in Obesity: Another reason why people who are obese are more likely to have gallstones is related to cholesterol levels. The higher the fat percentage in the body, the more cholesterol the liver secretes into the bile. As cholesterol levels in bile become excessive, the cholesterol becomes insoluble, forming crystals that eventually turn into stones.
- Decreased Gallbladder Contractions and Bile Stasis: Obesity is also related to lower motility of the gallbladder. In a normal gallbladder, there is a regular contraction to excrete bile. In obese individuals, there may be a lack of contraction or a sluggish contraction, thereby causing bile to be retained in the gallbladder for an extended period. This condition is called bile stasis.
- Insulin Resistance and Hormonal Alterations: Insulin resistance, often related to obesity, may also impact lipid metabolism. Higher levels of insulin push cholesterol secretion into the bile, while simultaneously reducing the amount of bile acids that act to help keep cholesterol in solution. Changes in hormonal levels due to obesity may further lessen gallbladder activity, leading to an increased risk of gallstones.
- Rapid Weight Loss Can Increase the Risk: Rapid weight loss, either through crash diets or because of bariatric surgery, further raises the risk of gallstones in obese individuals. Large quantities of cholesterol are released into the blood when fat is broken down at a rapid rate and into the bile. At the same time, lesser food intake results in a lesser frequency of emptying of the gallbladder, which encourages stone formation.
- Inflammation and Metabolic Stress: Obesity is a chronic inflammatory state. The low-grade inflammation compromises liver function and the bile composition, making the bile thicker and lithogenic. Added to this metabolic stress is yet another layer of risk when obesity is combined with other conditions, such as fatty liver or metabolic syndrome.
Prevention by Sustainable Weight Management
The most effective approach to diminishing gallstone risk is through maintaining a healthy weight by ensuring gradual and sustainable lifestyle changes. This will keep the cholesterol levels in order and give a supportive feeling to the gallbladder with a high intake of fiber, frequent exercise, and avoidance of extreme dieting. If there is a case of sudden massive weight loss, then medical advice will help in reducing the risk of gallstones.