Local surgeon links gallbladder issues with GLP-1, urges caution with weight loss plans

THE WOODLANDS, TX – A primary shift in the treatment of diabetes and weight loss began just a few short years ago but has exploded to one of the most major hot-button topics of modern healthcare – the use of GLP-1 (or, more accurately, GLP-1 agonists, that, once entering the body system, activate the GLP-1 receptor with a result of lower blood sugar and reduced appetite).

GLP-1 agonists gained widespread popularity only within the past five years, driven by their dramatic effectiveness in weight loss and growing media attention. While the first GLP-1 drug was approved in 2005 for type 2 diabetes, it remained largely within medical circles for years. The shift began around 2018 - 2020, when clinical trials demonstrated significant cardiovascular benefits and substantial weight loss with drugs like semaglutide, known more popularly by the name Ozempic.

As millions across the globe embrace GLP-1s for their weight loss plans, a critical public health concern is emerging: a two-to-four-times increased risk of gallbladder disease issues such as gallstones and inflammation, as well as thyroid cancer signals. With GLP-1 sales projected to hit $100B by 2030, this has become one topic of interest and concern to one local surgeon.

Dr. Jantzen Thorns is a U.S. Army veteran and general surgeon with more than 20 years of experience, known for robotic and colorectal surgery, gallbladders, digestive disorders, hernia, thyroid, and more. From his offices at Baylor St. Luke's Medical Group at Vintage General Surgery, he specializes in a wide range of surgical procedures and treatment for a variety of conditions, focusing on surgical areas such as gallbladder, colorectal, gastrointestinal, hernia, thyroid, pancreatectomy, and skin and soft tissue procedures.

“While GLP-1 medications offer significant benefits for many patients managing diabetes and obesity, it’s vital that we as clinicians transparently discuss the potential for gallbladder complications," he said. “Knowing the symptoms and having a clear action plan, which often involves collaboration between primary care, gastroenterology, and general surgery, ensures patients can achieve their health goals safely and effectively address any concerns that may arise.”

In the category of “be careful of what you wish for,” dieters using this latest trend have discovered that rapid weight loss is one of the most significant factors linked to gallstone formation. GLP-1-related rapid reduction in body fat can alter bile composition, making gallstones more likely to form. Additionally, the slower emptying of the stomach – which is a key effect of GLP-1 use – could potentially impact bile flow and increase the risk of gallstone formation.

Thorns rushes to emphasize that not everyone taking a GLP-1 will develop gallbladder problems. The risk is elevated compared to those not on the medication, but adverse medical issues are not a given. He argues that GLP-1 treatments are incredibly effective, helping many achieve significant health improvements; but, like any medication, it’s essential to understand potential side effects.

“This isn't to diminish GLP-1 benefits, but to illuminate a crucial need for informed consent, proactive monitoring, and continued research as these drugs become commonplace,” he said, warning that the largely media- and influencer-driven ‘weight loss at any cost’ narrative can gloss over the benefits versus perils of breakthrough treatments like GLP-1s.

He encourages those either on or considering GLP-1 to keep vigilant on symptoms of gallbladder issues, stressing the need to seek prompt medical attention in the presence of:

Sudden and intensifying pain in the upper right abdomen or center of your abdomen; this pain might radiate to your right shoulder or back

• Pain that lasts for several hours
• Nausea and vomiting
• Fever and chills
• Yellowing of your skin or the whites of your eyes (jaundice)
• Dark urine or light-colored stools

If starting a GLP-1 regimen, Thorns encourages you to discuss your medical history with your doctor beforehand, especially with preexisting gallbladder issues or your heightened risk for them; high-fat diets and lack of exercise can easily contribute to gallstones and inflammation.

While the potential for gallbladder issues might sound concerning, it shouldn't deter you from considering GLP-1s if they are recommended by your healthcare provider. The benefits for many outweigh the risks, especially when those risks are understood and managed. Thorns points out that gastroenterologists and general surgeons are especially equipped to provide pre-treatment advice and post-complication relief.

“If surgery is required – and for symptomatic gallstones or cholecystitis, it often is – a general surgeon is the expert you'll need. We are highly skilled in performing gallbladder removal, often done using minimally invasive laparoscopic techniques. This is a very common and safe procedure that effectively resolves most gallbladder issues. Early intervention results in increased and improved quality of life.”

The takeaway that Dr. Thorns wants people to have is to not let fear prevent them from pursuing their health goals with medications like GLP-1s. Instead, he encourages people to empower themselves with knowledge and know who to turn to if questions or concerns arise.

“By being proactive and communicating openly with your medical team, you can navigate your health journey confidently.”