Warning to weight losers

Attention to all fast-weight-losing individuals: Increased mobilization of fat stores inevitably leads to the mobilization of cholesterol. Excess cholesterol is processed by the liver and excreted through the bile into the intestinal tract. Therefore, any individual that is in a fast weight loss program, or have undergone bariatric surgery (stomach stapling) may end up with precipitation of bile in the gallbladder and the formation of stones (Cholecystolithiasis). You might have lost large amounts of body fat, either fast or over a prolonged period. If either case, you are at risk of gallbladder stones. You may be susceptible to gallbladder stones unless you are in a ketogenic regimen, or a low-carb, high-fat alternative. That is right, dietary fat may prevent gallbladder stones. Why? because dietary fat stimulates the motility of the gallbladder, so it will keep the bile moving.

My experience

Just to recap my own story, I started Intermittent Faster (IF) as One-Meal-A-Day (OMAD) in 2009. In March 2012 I had to go to emergency with upper right abdominal pain. I had had a couple of similar episodes, but they did not last more than 1 hr. Those episodes came and went very quickly. The March 2012 episode was more sustained, so I was treated for pain and underwent ultrasound examination, which demonstrated the gallbladder stones. I immediately underwent surgery. By the end of that year, I had an additional episode, but it faded as fast as it appeared and I have not experienced any other episodes since. The surgery was curative.

Let me be clear about this: Gallbladder stones are not directly linked to fasting, but it is caused by rapid or consistent weight loss. In my case, I started OMAD at 227lb (Nov. 2009) and was 190lb at surgery (Mar. 2012). Eventually, I went down to 161lb in 2014. I could have prevented the surgery by changing my diet just a bit. As a typical baby boomer, my diet was high-carb and low-fat. Before starting my OMAD regimen, I always ate starchy foods plus fish or chicken. I rarely ate meat, disliked butter, and did not eat eggs routinely. Other favorable sources of fat, such as avocados and nuts were rare in my diet. Once I started OMAD, I continued my diet as it was. I did not want to change my preferences, my goal was to make it as easy as possible. Today, we know a whole lot more about fasting and the ketogenic diets than it was known back in 2009. In fact, I would suggest you do your own research and start with this scientific article published in 2014.

Preventing Gallbladder stones

If you have already experienced right upper abdominal pain episodes, you need to consult your doctor right away. It is possible that you already have gallbladder stones and need to be treated for them. However, if you have not experienced the pain and have a lot of weight to lose ahead of you, you might need to modify your diet just a bit. Increasing the fat in your diet could be simple: Avocado, coconut, olive or avocado oil may be easily incorporated into your diet, along with nuts such as macadamia, pecans, peanuts or pistachios may provide good fat that will stimulate gallbladder movement. However, if you introduce more fat into your diet and experience upper abdominal pain, it may be that you already have gallbladder stones and did not know about it. You can keep track of your macronutrients using the application on this website: www.MyFitnesPal.com.

The Ketogenic diet

I have no personal experience with the ketogenic diet. However, I have been thinking that reducing carbs to almost zero and increase the fat content might be unsustainable and have adverse effects. Well, here is one instance in which eating fat would have saved me a visit to the operating room. However, I wonder if a gallbladder stone patient starting a ketogenic diet would end up with a painful episode. Again, it is important to be aware that this is a possibility. You may have gallbladder stones and not know about it. In my instance, I had an acute episode, following a fatty meal I was not used to eating while traveling in Spain. Although a fatty diet may prevent the formation of gallbladder stones, it may trigger of right upper abdominal pain.

OMAD or not

OMAD is no more a cause of gallbladder stone than a bariatric surgery is. If you choose the ketogenic diet, you may have the preventive measure built into your plan. However, the benefits of OMAD alone, compared to the ketogenic diet far justify the risk of gallbladder surgery. OMAD, for example, stimulates autophagy, which has many benefits in health and longevity. OMAD also promotes the prolonged secretion of growth hormone and testosterone that benefit muscle growth. Yet, preventing gallbladder stones with OMAD is just a matter of not letting your dietary fat be too low.

If you plan to lose a lot of weight, don’t be afraid of dietary fat. We know now that dietary fat is not going to make you fatter or prevent you from losing body fat. Sugar and carbohydrates in the diet, if kept high, will promote insulin resistance, obesity, and diabetes. Your healthier alternatives are the ketogenic diet and OMAD (or other forms of IF). They will both prevent or help reverse diabetes and obesity.

What if

What would I have changed at the start of my OMAD, if I knew then what I know now? When I started my OMAD regimen, I kept a carbohydrate-based diet. As I started to become more fit, lift weights and do strenuous calisthenics and, I increased my protein intake. However, I only started this intense program months after my surgery. Only recently, I have learned about the ketogenic diet and the misconceptions about fat, cholesterol and heart disease. Therefore, if I knew in 2009 what I know now, I would have included more healthy fats in my diet and not be so afraid of animal fats. There are good vegetable fats, though, the choice is yours. Deep frying some good veggies like sweet potatoes, carrots and plantains in coconut oil are some of my favorite foods now. My wife cooks very delicious keto-desserts (look elsewhere in this site). So preventing gallbladder disease is not a big issue for an OMADer. One last reminder: see your doctor if you have experienced upper right abdominal pain. Watch for pain in this location if you have lost a lot of body fat.