Weight gain after gallbladder operations continues to be a hot topic on the DietDoc Forum.
Many people seem to believe that once they have had their gallbladders removed, they will have to change their diet completely and that they will automatically gain weight.
Both these perceptions are wrong.
How the gallbladder works
To understand what happens when you have your gallbladder removed, we first need to look at the function of this 'storage sack'.
Basically, gall or bile is produced in the liver and then stored in the gallbladder until it is required for digestion. At this point, the gallbladder releases gall into the digestive system (the small intestine) to help with the digestion of fats.
It is important to keep in mind that gall or bile is produced by the liver, which is not removed when you have your gallbladder removed. After your operation, bile production will continue as before. You will still be able to digest fatty foods after your gallbladder op and there is no reason why you will not be able to eat a normal diet, which contains some fats.
It is also important to remember that the gallbladder is just a sack-like structure which the body uses to store gall or bile. If this sack is removed, the liver goes on producing gall, but instead of storing it in the gallbladder, the gall is excreted directly into the digestive tract to do its work in helping you to absorb fats.
In most cases, the so-called biliary tract in the liver widens or dilates to form a 'simulated pouch' for the temporary storage of bile (Krause, 2000).
So, physiologically you will really not be different after your gallbladder op. Your liver will still produce bile. The bile will be poured into the digestive tract, where it will assist with the absorption of fats. It is even probable that your body will make a 'new' storage pouch to store bile.
Why is there a risk of weight gain?
"But", I hear you say, "I have heard that it is inevitable that I will gain weight after having my gallbladder removed?"
To answer this question, I searched for scientific publications (not anecdotal stories) that report on weight gain after gallbladder operations.
Researchers at the Department of Surgery at the Waterford Regional Hospital in Ireland did a study to find out if removal of the gallbladder leads to weight gain or not. The researchers followed up on 42 patients who had undergone simple laparoscopic removal of the gallbladder (key-hole procedure) and 42 patients who had undergone other operations for a period of 3 years.
Patients who had the gallbladder ops gained weight and increased their BMIs by an average of 1,8 kg/m2, and women were particularly susceptible. Patients who did regular exercise after their procedures were less likely to gain weight.
According to Dr Ali and his team, "Laparoscopic cholecystectomy (removal of the gallbladder using key-hole surgery) relieves symptomatic cholelithiasis (gallstones), but may facilitate postoperative gluttony." (Ali et al, 2004).
What the doctor means is that patients who suffer from gallstones, and associated nausea and other debilitating symptoms, probably have been eating less in general and less fat in particular before their operations.
A low-fat intake to avoid the symptoms of gallstones would help the patient to either lose weight, or keep their weight under control. Once the gallstones are removed and the unpleasant symptoms disappear, there is no longer a reason for these patients to limit their fat intake, so they start eating fat again, often in large quantities, and this may cause them to gain weight.
It is therefore highly likely that patients who start eating large quantities of fatty foods after their operations will gain weight, but this is not an automatic result of the procedure. Instead, it is an indulgence in foods that are high in kilojoules.
How to prevent weight gain
It you have had a gallbladder operation, it is important not to start eating loads of fatty foods once your symptoms improve.
Stick to a balanced, low-fat diet which will not only prevent weight gain, but that will ensure that you don't develop raised blood fat levels, and associated heart disease, or certain types of cancer. Be as active as possible and do aerobic exercise on a daily basis for 30 minutes or longer.
It is evident that having a gallbladder operation will not require you to eat a special diet for the rest of your life. However, you do need to make sure that you do not develop 'postoperative gluttony', as Dr Ali and his co-workers put it, and that you follow a low-fat, balanced diet, as well as an exercise programme, to ensure that you don't gain weight afterwards.
Dr I.V. van Heerden, DietDoc
4 June 2007
(Ali RB, et al (2004). Weight gain after laparoscopic cholecystectomy. Irish Journal of Medical Science, Vol 173(1):9-12; Krause's Food, Nutrition, & Diet Therapy, 10th Edition. LK Mahan & S Escott-Stump Editors, WB Saunders Co, Philadelphia. USA)
Diet and gallbladder disease