Obesity and Gallbladder Disease

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How to calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Gallbladder is a small organ under the liver with a function of aiding the digestive system in fat metabolism with storing of the bile produced by the liver. Gallbladder Disease is defined as a condition of inflammation or gallstones of the Gallbladder. According to the statistic, approximate 20 millions of US population have some kinds of Gallbladder Disease.

D. How Obesity associates with Gallbladder Disease
1. According to the study of "Triglycerides and gallstone formation" by Smelt AH., posted in PubMed, researcher stated that Changes in bile acid (BA) metabolism and gallbladder function are critical factors in the pathogenesis of gallstones. Patients with hypertriglyceridemia (HTG) - often overweight and insulin resistant - are at risk for gallstone disease......

2. In a study of "Gallstone prevalence and risk factors for gallstone disease in an urban population of children and adolescents" by Kratzer W, Walcher T, Arnold F, Akinli AS, Mason RA, Denzer C, Böhm B, Imhof A, Hänle MM., posted in PubMed, researchers found that Three adolescents (one girl, two boys), corresponding to a prevalence of 1.0 %, showed gallstones. One 14-year-old girl and one 17-year-old boy were overweight using Cole's classification. A positive family history and female gender could not be confirmed as risk factors and concluded that Obesity appears to be a risk factor in the development of gallstones in childhood and adolescence.

3. In the abstract of the study of "[Gender and obesity--what does "being fat" mean to boys and girls?] [Article in German]" by Wiegand S., posted in PubMed, researchers indicated that Despite great differences in sex hormones girls and boys are equally affected by overweight and obesity even during puberty. Comorbidity in general also has a similar prevalence. However, there are certain sex differences. Boys are more prone to steatohepatitis whereas girls more commonly develop gall stones and pseudotumor cerebri. Quality of life in respect to health is impaired in all children and adolescents with obesity.

4. In a study of "Epidemiology of gallstones" by Stinton LM, Myers RP, Shaffer EA., posted in PubMed, researchers found that certain risk factors for gallstones are immutable: female gender, increasing age, and ethnicity/family (genetic traits). Others are modifiable: obesity, the metabolic syndrome, rapid weight loss, certain diseases (cirrhosis and Crohn disease), gallbladder stasis (from spinal cord injury or drugs, such as somatostatin), and lifestyle.

5. According to the study of "Epidemiology and risk factors for gallstone disease: has the paradigm changed in the 21st century?" by Shaffer EA., posted in PubMed, researchers found that Our abundant access to food places us at the increased risk of obesity and cholelithiasis. The general rise in obesity in many countries raises the specter of heightened disease, best identified by epidemiologic studies.

6. Etc.

E. Treatments of Obesity and Gallbladder Disease
1. According to the abstract of the study of "Apply influence diagrams for utility analysis of paying the weight-reducing expenses: a case study in taiwan" by Wu F, Sun PR, Chang CC., posted in PubMed, researchers found that if Taiwan's NHI provides reasonable benefit for weight-loss outpatient services, not only the risk of people suffering from diabetes, hypertension, hyperlipidemia, cardiovascular disease, gallbladder disease, cancer, gout, arthritis, etc. will go down; but also the medical expenditure can be effectively reduced.

2. In a study of "Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding for morbid obestity" by Al-Jiffry BO, Shaffer EA, Saccone GT, Downey P, Kow L, Toouli J., posted in PubMed, researchers found that rapid weight loss following laparoscopic gastric banding impairs gallbladder emptying and when pronounced, gallstones form by six weeks postoperatively. The accompanying reduction in gallbladder emptying, increased gallbladder residual volume and decreased refilling promote gallbladder stasis and hence stone formation.
3. In another study of "Prevention of gallstone formation in morbidly obese patients undergoing rapid weight loss: results of a randomized controlled pilot study" by Wudel LJ Jr, Wright JK, Debelak JP, Allos TM, Shyr Y, Chapman WC., posted in PubMed, researchers concluded that This pilot study confirms the high incidence of gallstone formation (71% of assessed patients) associated with rapid weight loss in patients undergoing gastric bypass. Despite active enrollment in a supervised prevention trial, the two therapies investigated to reduce gallstone formation were not efficacious, likely because compliance with medical therapy was poor. These findings highlight the significant risk of gallstone formation in this patient cohort even when prevention strategies are utilized.

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