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Weight loss injections and gallstones

Weight loss injections and gallstones

Weight loss injections, like Mounjaro and Wegovy, can increase the risk of gallstones forming. Gallstones aren't always a serious health complication, but if they cause a severe, intense pain, they require urgent medical attention.

Ways to reduce your risk of getting gallstones while on a GLP-1 injection include managing your diet and increasing your activity levels.

Alexandra Cristina Cowell
Medically reviewed by
Alexandra Cristina Cowell, Writer & Clinical Content Reviewer
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Medically reviewed by
Dr Alexandra Cristina Cowell
Writer & Clinical Content Reviewer
on Feb 26, 2026.
Meet Alexandra Cristina  
Alexandra Cristina

Last updated on Feb 27, 2026.

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  • Weight loss injections can slightly increase your risk of developing gallstones, especially if you’re on a higher dose or use them for a long time.
  • Losing weight quickly changes how bile is made and released. This can cause bile to sit in your gallbladder for too long and form crystals that turn into gallstones.
  • Many people have gallstones without knowing. Problems usually only happen if a stone blocks a bile duct, which can cause severe and constant pain.
  • Losing weight gradually; eating regular, balanced meals; staying hydrated; and exercising regularly all help to keep bile moving and reduce the risk of gallstones forming.

The link: Do weight loss injections cause gallstones?

Yes, there’s an increased risk of getting gallstones while using GLP-1 injections. And there are several reasons for this, such as rapid weight loss and impaired gallbladder movement.

Why do weight loss injections increase gallstone risk?

There are many reasons why GLP-1s are associated with an increased risk of gallstones, most of which are listed below. Understanding how gallstones form helps explain this link.

Gallstones typically develop when bile remains in your gallbladder for long periods and becomes saturated with cholesterol or bilirubin, allowing crystals to form and grow.

Bile stasis and crystallisation

One of the ways that GLP-1s prompt weight loss is by delaying stomach emptying, which makes you feel fuller for longer. But this mechanism also slows down your gallbladder’s movements and contractions. When the gallbladder doesn’t contract properly, it can slow bile flow, leading to bile stasis (where it sits in your gallbladder for too long).

When bile sits for too long, it allows cholesterol to crystallise, increasing the risk of gallstones.

Reduced secretion of CCK (cholecystokinin)

CCK is a hormone that’s important for normal gallbladder contraction. It stimulates the gallbladder to empty bile into your small intestine

GLP-1 suppresses the release of CCK, which reduces gallbladder contraction. As a result, bile remains in the gallbladder for longer periods, increasing the risk of cholesterol crystallisation and gallstone formation.

Rapid weight loss

During rapid weight loss, more fat is broken down, causing your liver to secrete more cholesterol into bile. At the same time, reduced food intake means your gallbladder empties less often. This combination creates bile that is cholesterol-rich and poorly drained, promoting crystallisation and gallstone formation.

Altered FGF19 and GLP-2 signalling

FGF19 and GLP-2 are two chemicals that help contract and relax the gallbladder. GLP-1 can reduce FGF19 and GLP-2 signalling, which can lead to your gallbladder contracting and relaxing more poorly. This can promote bile stasis, increasing gallstone risk.

Understanding gallstones

Gallstones are formed when bile crystallises, either with cholesterol or bilirubin, creating small pebble-like stones.  

Typically, gallstones are asymptomatic, meaning they don’t cause any symptoms. But they can sometimes cause severe, persistent pain in the upper right part of your abdomen. 

What symptoms should I look out for?

Most of the time, gallstones don’t cause any symptoms. But if they block the bile duct, it can result in intense pain in your abdominal area and back. This pain is usually intense and constant, lasting for several hours. It’s typically felt on the right or middle of your stomach.

Other symptoms might include:

  • Fever
  • Fast heartbeat
  • Jaundice
  • Nausea or vomiting

If the pain lasts longer than 30 minutes, seek immediate medical attention. Leaving it untreated can lead to more serious complications and health risks. 

Can you pass gallstones?​

If the stone is small enough, you can pass it through stool, but this is rare because gallstones are often too big to pass, causing them to get stuck in your bile duct. When this happens, intense pain is felt and surgery is needed to remove them. 

Non-medical professionals may recommend using apple cider vinegar, olive oil, or herbal remedies to help break them down so they can pass naturally, but these remedies aren’t always backed scientifically. It’s best to speak to your doctor if you have gallstones so they can decide the best treatment approach for you. 

Who’s most at risk?​

You’re more at risk of gallstones if you:

  • Are over 40
  • Are female
  • Have obesity
  • Experience rapid weight loss
  • Are of Native American or Hispanic ethnicity
  • Have diabetes
  • Have Crohn’s disease
  • Take certain oral contraceptives

Managing gallstones while using a GLP-1

It’s not necessarily dangerous to use a GLP-1 if you have gallstones, but you should only do so under the supervision of a doctor.

Can I start Wegovy or Mounjaro if I have gallstones?

If you don’t have symptoms of gallstones, you can use weight loss injections like Wegovy or Mounjaro. But it’s important to take them only under your doctor’s supervision so they can monitor your health throughout the treatment. 

Your doctor may also assess your risk of developing gallstones before starting treatment to ensure everything is okay. In certain cases, your doctor might decide not to prescribe GLP-1 injections or may advise against them if they believe the risk of developing gallstones is too high.

Can I use injections if my gallbladder’s been removed?

Yes, you can use GLP-1 injections if your gallbladder is removed. In fact, it might even be beneficial as it reduces your risk of gallstone disease. 

GLP-1s don’t rely on the gallbladder to lose weight; without it, you can still lose weight effectively and safely. 

Are gallstones dangerous if left untreated?

Asymptomatic gallstones usually don’t require treatment. But if a gallstone becomes stuck in your bile duct and causes severe, long-lasting pain, urgent treatment is required.

Treatment typically involves keyhole surgery to remove the gallbladder through small incisions. In more severe or complicated cases, a more extensive surgical approach may be necessary.

If left untreated, gallstones can lead to inflammation of the gallbladder, gallbladder rupture, serious infections, and, in rare cases, gallbladder cancer.

Prevention and diet

You can reduce your risk of gallstone formation through diet and lifestyle changes.

How to reduce your risk while losing weight

Here’s how you can reduce your risk of gallstones:

Lose weight gradually

Start on the lowest dose of GLP-1 injections and gradually work your way to the highest dose. If you're at higher risk of developing gallstones, consider remaining on a lower dose for longer before moving to the next dose.

Eat regular, balanced meals

While it's important to be in a calorie deficit, you shouldn't miss meals. Instead, opt for low-calorie, nutrient-dense foods at regular times. Make sure your diet has plenty of fibre to help with bowel movements and reduce bile stasis.

Eat a minimum of three meals a day, with lots of vegetables, fruits, nuts, legumes, starchy carbohydrates, and healthy fats. Avoid foods high in cholesterol, saturated fats, and oily foods. It's also best to limit alcohol.

Stay hydrated

Drinking plenty of water throughout the day can help prevent gallstones. Water encourages gallbladder movements and contraction, which prevent bile stasis and crystallisation. While it can’t get rid of existing stones, it can stop new ones from forming.

Get regular exercise

Engaging in physical activity stimulates bowel and gallbladder movement, which can help reduce the risk of gallstones. Aim to exercise for at least 150 minutes of moderate activity per week, or 90 minutes of vigorous exercise.

If you experience mild stomach pain, consider opting for low-intensity workouts such as walking or yoga.

Best foods to eat (and avoid) for gallbladder health

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