Maintain your weight, avoid gallstones

Obesity is known to be a strong risk factor, in and of itself, for the formation of gallstones. We also know that rapid weight loss, like that seen in those who have weight-loss surgery, is also a risk factor for gallstones. Those painful little stones, often formed of cholesterol crystals, are more often seen in women than in men, and studies of gallstone risks are often focused on women. The latest issue of the Archives of Internal Medicine (2006;166(21):2369-2374), however, contains a fascinating look at men's risk of gallstones.

These researchers, from the University of Kentucky, Harvard, and the National Institute of Health (NIH) utilized data from the Health Professionals Follow-up Study, a prospective study of 51,529 male health care professionals who were between 40 and 75 years of age in 1986. After responding to an initial mailed questionnaire, the study participants responded to follow-up questionnaires every two years. Their height and weight were among those items followed, as were diet and exercise.

In 1992, 24,729 men also reported on their intentional weight loss (if any) in the previous four years. The questionnaire that year asked the respondents to state, "how many times did you lose each of the following amounts of weight" in the past four years: 5 to 9 pounds (2.3-4.1 kg), 10 to 19 pounds (4.5-8.6 kg), 20 to 49 pounds (9.0-22.1 kg), and more than 50 pounds (over 22.5 kg). These men were then followed through 2002 and asked to report any diagnosis of gallstone disease.

For those men who were clinically diagnosed with gallstones, the researchers compared the weight loss and gain amount and frequency of those who did intentionally lose weight with those men whose weight remained constant (within 5 pounds of their initial weight). They found that even after controlling for known and suspected risk factors for gallstones, those men who intentionally lost weight were at higher risk for gallstones. The risk increased with more weight lost at a time, as well as losing and regaining weight more than once. In fact, men who lost and regained more than 20 pounds (9.1 kg) had an increased risk of gallstone disease of 40%.

What this means for you:

This study is consistent with similar studies on women and gallstones. If you're overweight, we know that you'll be much healthier at a normal Body Mass Index. Yet dieting as most Americans practice it usually means losing and regaining weight over and over again. Lose the weight and keep it off, not by dieting, but by choosing a healthier lifestyle that includes exercise and consistently choosing foods that are better for you.

First posted: November 28, 2006