Gallbladder Disease

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How Obesity Increases the Risks of Gallbladder Diseases (and Gallstones)

Gallstones and gall bladder disease are so prevalent that more than 25 million Americans have them and at least a million are diagnosed each year, according to a recent article from 2009. (1) According to all the information available, women are much more likely to develop gallstones and gall bladder disorders than men. Additionally, pregnancy, raised estrogen levels as well as risk factors from hormone replacement therapy make the chances of developing gall bladder disease or gallstones more likely. Another major cofactor for the development of gall bladder maladies is obesity.

Obesity is a condition that affects a very large number of people worldwide, in fact it is so prevalent that it has become an epidemic. (2) Obesity is defined as having a body mass index (BMI) greater than 30.0 kg/m2, while being overweight is a BMI between 25.0 kg/m2 and 29.9 kg/m2. (3) Obesity is just one of the more visible symptoms of a larger set of illnesses collectively called metabolic syndrome. (4) A person identified as suffering from metabolic syndrome is at high risk of developing seriously life-threatening illnesses such as cardiovascular disease, diabetes mellitus, disorders and cancers of the liver, stomach, bowels, kidneys, pancreas, gall bladder and other gastrointestinal tract issues. (5) Therefore, obesity is a serious condition that needs to be addressed as soon as possible with weight loss and diet change, as well as surgery if no other alternative is available. (6)

Obesity and gall bladder maladies

People who suffer from diabetes have a higher risk factor for developing gall bladder disorders and gallstones. Type 1 diabetes is genetic and develops early on in a person’s life, so it is not directly related to obesity, although staying at a normal body-weight certainly does improve the quality of life for someone suffering from this condition. (7) On the other hand, type 2 diabetes develops as a result of obesity, so it is important to remember that anyone can be afflicted with this condition. (8) One of the gall bladder’s many functions is the conversion of cholesterol into bile. Gallstones are usually formed by high concentrations of cholesterol that have become calcified, (9) so it is likely that sufferers of gallstones who are also diabetic have high cholesterol in their blood as well. (10) Cholesterol in the blood is regulated by insulin created in the pancreas. (11) A person with type 1 diabetes has a pancreas that cannot create insulin and a person with type 2 diabetes has so much insulin in their blood that the body becomes desensitized to its effects. (12) Thus, obesity, high cholesterol levels and insulin are all intricately related to the potential development of gallstones.

Obesity is also a risk factor because the cholesterol is produced by the liver. (13) If the liver is producing too much cholesterol, it is delivered into the gallbladder and converted into bile. (14) However, if there is too much cholesterol then the gallbladder cannot deal with the quantities and therefore becomes supersaturated with cholesterol. (15)

Rapid weight-loss and weight-gain is also one of the cofactors for gallbladder disorder. (16) The risk of gallstones increases by 12% after a lengthy calorie-restricted diet and the risk is a staggering 30% higher 12-18 months following gastric bypass surgery. (17) Those who go through bariatric surgery and other surgeries for dealing with obesity are also at a greater risk of getting gallstones. (18)

Metabolic syndrome and cholesterol

Gallstones and gall bladder issues are related not just to obesity, but to metabolic syndrome as a whole as well. (19) Obesity in the form of adipose tissue around the central part of the body is one of the highest correlating risk factors to gallbladder issues, as well as low HDL cholesterol, high triglycerides, high blood pressure and high blood sugar. (20) Additionally, it should be noted that cholesterol as a whole itself is not responsible for the risks of gallbladder stones, but it is that HDL cholesterol (often called “good” cholesterol) levels are too low, which causes the imbalance in the bloodstream producing too much insulin and leading to metabolic syndrome, obesity and gallstones as well.  (21)

Diet, obesity and gallstones

Even though it might make sense to conclude from all of this that an improper diet is a risk factor for developing gallstones, there has not been a study that showed a clear relationship between diet and gallstone formation. (22) This is not, however, to say that low-fiber, high-cholesterol diets and diets high in starchy foods have not been suggested as contributors to the possibility of gallstone formation. (23) There have also been some links showing that wine and whole-grain bread may decrease the risk of gallstones. (24)

As with any of the other disorders in the metabolic syndrome that are heavily related to obesity, it’s important to have a balanced diet that covers a broad range of foods, including protein, fat, carbohydrates, minerals, vitamins and other nutrients. Any imbalances in these foods can cause a number of problems that are all part of the metabolic syndrome and can contribute to obesity and gallstones. High blood sugar is also known to contribute to obesity and other related problems and if a person is eating a lot of refined carbohydrates and sweet food or drinks, you can make your blood sugar spike significantly causing too much insulin to be released from the pancreas. If cholesterol, insulin, triglycerides and any number of other of these substances get out of control in the bloodstream then they can all contribute their part to the obesity epidemic and the formation of gallstones.  A lack of fiber can also contribute to too many solids in the gastrointestinal tract, leading to accumulation of bile in the gallbladder and disorders. A healthy regime of exercise several times a week can also contribute to having a life free of gallstones.