For many, cholecystectomy or gallbladder removal is the only promise of relief from all their gallbladder pain and trouble. This makes the procedure one of the most frequently performed surgeries. Deciding to have it was made even easier with the development of laparoscopic cholecystectomy. Due to its less invasive nature, healing time and recovery are much quicker, with most patients out of the hospital and back to their normal lives in no time. However, just as they think all their worries are over, many discover that they need to face a new kind of challenge – weight gain after gallbladder removal.
Weight Gain After Gallbladder Removal
The fear of gaining a few pounds is common, especially during the holiday season. Unfortunately for many people with gallbladder concerns including those who have had a cholecystectomy, the struggle of weight gain after gallbladder removal is constant the whole year-round. You may be one of many who are hoping to know the reasons behind this. Some causes are directly related to the surgery while others are less direct. To help you understand the problem of weight gain during gallbladder surgery recovery or even long after the procedure, we have researched and listed five possible causes of weight gain after gallbladder removal.
- Metabolic changes
- Faulty fat digestion and metabolism
- Insulin Resistance
Although surgical removal of the gallbladder is not as incapacitating as taking out other organs, its absence can still have a significant impact on our bodies. There are numerous changes post-operation that alter the body’s metabolic and digestive processes leading to weight gain after gallbladder removal.
In some experiments using animal subjects, it showed that cholecystectomy results in elevated triglycerides in both the blood and the liver, and VLDL (the bad cholesterol) production. It also increases bile acids recirculation rates resulting in increased tissue exposure to bile acids. This affects energy balance, body weight, glucose levels, and insulin sensitivity. The removal of the gallbladder even increases biliary bile acids and cholesterol secretion rates. These changes in the body suggest that people who have had their gallbladders removed may have a higher risk of developing metabolic syndromes and other complications such as type 2 diabetes, heart diseases, and the accumulation of fat in the liver.
Faulty fat digestion and metabolism
When the gallbladder fails to work properly, the quality of the bile produced and circulated is affected significantly. It can get too thick or can turn into sludge, causing stagnation. Over time, this can lead to gallstones that may impair the emptying of the gallbladder. When this happens, the much-needed fats and fat-soluble vitamins are not absorbed by the body. In order to cope with less fat, our bodies go into starvation mode, preserving and holding on to the fat they already have. This can be a reason for weight gain for those with gallbladder problems.
For those who have undergone cholecystectomy, the body still experiences drastic changes. Without the gallbladder’s regulating function, bile is secreted into the small intestine at a slow and steady rate. The bile produced by the body may be insufficient in amount or too diluted to do its job efficiently leading to faulty digestion and metabolism of fat. Apart from weight gain, this can also manifest in either diarrhea or constipation.
Diet plays a major role when it comes to weight management. Whether a person has gallbladder issues or not, eating much more than your body needs would definitely cause an increase in weight. This is often the case with patients who have had their gallbladders removed. In a study following subjects post-cholecystectomy, 75% of patients gained weight just a few months after the operation. In other studies, they have identified that females are more likely to gain weight after gallbladder removal.
Here are a few assumptions from research papers as to why this happens:
- Patients tend to make an effort to lose weight as preparation for the surgery and they fail to maintain their weight loss after it has served its initial purpose.
- Many of the patients who have undergone surgery were overweight, to begin with
- Patients were not able to restrict themselves to a healthy diet, indulging in unhealthy fats just as they used to. Many patients also eat high-fat food that they weren’t able to eat before because of gallbladder issues. They end up ingesting more calories than they need. This attitude may be brought about by the thought that gallbladder removal will be able to solve all their problems. However, that is not the case.
Although inflammation is not a direct result of gallbladder removal, it is still a common cause of weight gain among those who have undergone cholecystectomy. There are many ways that inflammation can change our body’s homeostasis or normal balance, as proven by a number of studies linking chronic inflammation to weight gain.
Inflammation causes leptin, the “weight control hormone”, to be less efficient. This hormonal disruption affects our hypothalamus, increasing our appetites and slowing down our metabolism. Inflammation in the gut also leads to irregular appetite and increased sugar cravings. Inflammatory cytokines, released by fat cells also cause weight gain.
Sources of Inflammation
There are many possible sources of inflammation, not the kind that hurts, but the kind that makes you tired or depressed which makes you more inclined to gain weight:
Having gallbladder problems in the first place may be a sign that dietary concerns must be addressed. This can be brought about by food allergens, too much carbohydrate, bad cholesterol, or sugar.
2. Leaky gut
When someone has leaky gut syndrome, the walls of the small intestine become inflamed and irritated, allowing toxins to permeate into the bloodstream and become stored in our cells. A leaky gut is also known to be the cause of many gallbladder diseases.
Stress triggers the release of the stress hormone called cortisol. This powers up the “fight or flight” response but can cause disruption of metabolism and insulin levels if cortisol levels remain high for long periods of time. Stress also plays a big role in chronic inflammation and our immune system.
4. Hormonal changes and menopause
Aside from the fact that gallbladder problems usually happen during the peri-menopausal age or later in life, hormonal changes also contribute to weight gain after gallbladder removal through their role in chronic inflammation. Studies show that a decrease in estrogen corresponds with a rise in cytokines which causes inflammation in the body. Cytokines play a crucial role in aiding cell-to-cell communication during immune responses but pro-inflammatory cytokines can also stimulate the movement of cells towards trauma or infection sites.
Insulin resistance may be listed as one of the causes of inflammation. However, its prevalence (over 80 million Americans suffer from this) and the sheer number of complications it can bring about, demand that it be listed as an independent concern that anyone should be cautious about. Similar to inflammation, this is not directly caused by cholecystectomy, but it is a very common condition that can develop within the same high-risk group as gallbladder diseases, probably because insulin resistance is one of the causes of gallstone formation.
Insulin resistance is a precursor for the development of type 2 diabetes, and it is most often associated with fatigue and weight gain. It is a condition wherein body cells fail to respond normally to the hormone insulin, which helps in the absorption of glucose from the bloodstream. This leads to a build-up of sugar in the blood. High levels of insulin can induce the feeling of lethargy and can fuel sugar and carbohydrate cravings. Insulin resistance can not only cause weight gain, but it can also cause localized areas of fat growth.
Aside from the obesity threat that this condition poses, studies show that women who are insulin resistant are also at risk for hypertension, heart disease, high cholesterol, breast cancer, and polycystic ovarian syndrome (PCOS).
How to Avoid Weight Gain After Gallbladder Surgery
Looking at the different causes of weight gain, we can see that the common solution is keeping a healthy diet and lifestyle after gallbladder removal. Food choices, daily habits (including rest and exercise), and overall diet after gallbladder surgery can significantly affect recovery and post-operation quality of life. Here are some ways to help you prevent the dreaded weight gain:
- Eat right and be cautious of any possible vitamin deficiency
- Reduce inflammation with supplements and avoid pro-inflammatory foods
- Take supplements that enhance fat digestion
- Manage your stress levels
- Be sure to include moderate exercise in your daily routine
- Manage your blood sugar
Eating right means a lot of things – it means that you should eat moderately, eat on time and eat the right things. Some people resort to starving themselves and skipping meals to lose weight, only to binge a few hours or days later. However, our bodies do not operate that way. That often results in weight cycling or the rapid loss and then re-gaining of one’s weight. Moderation is always the secret. But of course, moderately eating the wrong food will not do you any good. If you were cautious about your pre-operation diet to avoid gallbladder attacks, you should treat your lack of gallbladder as a condition requiring as much care as before removing it. This is always true, but even more so for the first few months after gallbladder surgery.
It also means being aware of your blood sugar levels, keeping them balanced, and not letting them get too low or too high. Have your glucose levels checked by your doctor. To oversimplify, balancing blood sugar requires eating no sugar or refined carbohydrates and eating small frequent meals.
Make sure you have all the vitamins and minerals your body needs. Some may think that eating less would automatically cause weight loss, but the lack of some vitamins and minerals will actually contribute to weight gain. Having low levels of iron, magnesium, vitamin D, and vitamin B12 can alter your metabolism, drain your energy and compromise your immune system. Stay away from processed, high-sodium, high cholesterol, and sugar-loaded foods. Fresh and organic fruits and vegetables, low grain, and lean proteins may often give us our needed daily dose of vitamins.
Given the role of inflammation in weight gain, you should also make an effort to avoid any food or activities that will aggravate or start inflammation. Watch out for common allergens like gluten, dairy, soy, and peanuts. Triggering allergies will cause a wealth of problems beyond weight gain. Include anti-inflammatory foods in your diet, such as beets, fresh or dried turmeric root, coconut oil, chia seeds, and many more. You can never go wrong with a diet rich in omega-3, antioxidants, and essential fatty acids.
To help break down fats and aid in digestion, supplemental Bile Salts with taurine and choline are highly recommended. These coupled with the proper diet and exercise will help set you up to achieve and maintain your ideal weight.
Speaking of exercise, it is best to consult a professional about the type and the intensity of exercise program that you should indulge in. Unknown to many, it is possible for exercise to do you more harm than good. For one, research shows that people who push their bodies too hard may essentially undo the positive effects of exercise. Second, instead of boosting your happy hormones, exercising the wrong way can raise your cortisol levels and contribute to stress and weight gain. When you are trying to manage your stress levels, that kind of spike is the last thing that you need. Adaptogenic herbs, as well as fermented B vitamins, are both supportive of stress. Try Max Stress B for stress support.
The last tip for those concerned about weight gain after gallbladder removal is to have your blood sugars checked. Some patients, after trying to control their food intake and engaging in physical activity, still find themselves gaining weight or craving badly. This might be due to your blood sugar. To be sure you don’t have insulin resistance or diabetes, take the necessary tests. Natural products like chromium picolinate, banaba, and turmeric have been shown to help you keep blood sugar levels in check.
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Ali, R. B., Cahill, R. A., & Watson, R. G. K. (2004). Weight gain after laparoscopic cholecystectomy. Irish journal of medical science, 173(1), 9-12.
Amigo, L., Husche, C., Zanlungo, S., Lütjohann, D., Arrese, M., Miquel, J. F., … & Nervi, F. (2011). Cholecystectomy increases hepatic triglyceride content and very‐low‐density lipoproteins production in mice. Liver International, 31(1), 52-64.
Cortés, V., Amigo, L., Zanlungo, S., Galgani, J., Robledo, F., Arrese, M., … & Nervi, F. (2015). Metabolic effects of cholecystectomy: gallbladder ablation increases basal metabolic rate through G-protein coupled bile acid receptor Gpbar1-dependent mechanisms in mice. PloS one, 10(3), e0118478.
Houghton, P. W., Donaldson, L. A., Jenkinson, L. R., & Crumplin, M. K. (1984). Weight gain after cholecystectomy. British medical journal (Clinical research ed.), 289(6455), 1350.
Kwan, R. M. F., & Mir, M. A. (1985). Weight gain after cholecystectomy. British medical journal (Clinical research ed.), 290(6463), 243.