Weight loss medications, particularly GLP-1 receptor agonists such as semaglutide, have transformed the management of obesity in recent years. Their uptake in the UK has been rapid, and for many patients the results in terms of weight loss have been significant. However, as prescriptions continue to rise, a clearer picture is emerging of associated risks — and gallstone formation is one that clinicians are increasingly paying attention to.
Research linking GLP-1 medications with gallbladder issues
A 2026 cohort study published in the United European Gastroenterology Journal found that GLP-1 receptor agonist use was associated with a 59% higher risk of gallbladder and biliary complications over a three year period, with the association primarily driven by gallstone formation. The risk was notably higher with semaglutide and dulaglutide specifically.
This builds on earlier findings: a study published in Clinical Gastroenterology and Hepatology identified gallstone disease as a meaningful adverse event in patients using GLP-1 medications, particularly during the phase of rapid weight loss that typically follows the start of treatment.
The mechanism is well established. Rapid weight loss of any kind causes the liver to excrete more cholesterol into bile, which can become supersaturated and crystallise into stones. GLP-1 medications slow gastric emptying and reduce gallbladder contractility, meaning bile sits for longer and the conditions for stone formation are compounded. Very low calorie diets and bariatric surgery carry similar risks, but the scale of GLP-1 prescribing means more patients are now being exposed.
What are the symptoms of gallstones?
Many gallstones are asymptomatic and discovered incidentally. When symptoms do occur, they typically include episodes of sharp pain in the upper right abdomen, particularly after eating fatty food, along with nausea, bloating, and in some cases pain radiating to the shoulder. These episodes, known as biliary colic, can be severe and are often mistaken for other digestive conditions.
Complications including cholecystitis (infection of the gallbladder), pancreatitis, and cholangitis can develop if stones obstruct the bile duct. These are more serious presentations that require prompt medical attention.
When is keyhole gallbladder removal recommended?
For patients experiencing symptomatic gallstones or complications, the standard and most effective treatment is surgical removal of the gallbladder. Mr Michael Stellakis performs laparoscopic (keyhole) cholecystectomy, a minimally invasive procedure carried out with small incisions under general anaesthetic. Surgery typically takes between 30 minutes and three hours depending on complexity, and most patients return home the same day.
Recovery is generally straightforward. Most patients are pain-free and fully recovered within two to four weeks, and the procedure resolves gallstone symptoms in the vast majority of cases.
Importantly, it is possible to live well without a gallbladder, and most patients notice no meaningful difference in digestion once recovered.
For those currently taking GLP-1 medications who develop upper abdominal symptoms, early assessment is important. Identifying gallstone disease before complications develop means treatment is simpler, recovery is faster, and the risks associated with more complex biliary surgery are avoided.
To arrange a consultation with Mr Stellakis, call 01926 492969 or email admin@bowelandhernia.co.uk.
