Lost weight quickly, developed right-upper-quadrant pain after fatty meals, and ended up having an ultrasound that found what everybody had already guessed.
What I am after is how much of the gallbladder signal is the drug and how much is simply the rate of weight loss, because the answer changes what you can do about it.
Happy to be told the question itself is wrong.
This one has a reasonably settled answer, so here it is. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".
I would rather be corrected than agreed with, if it comes to it.
BariatricNurseD said:The dose-response is real but shallow at the top.
All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.
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View Resultslisa_labSD said:Lost weight quickly, developed right-upper-quadrant pain after fatty meals, and ended up having an ultrasound that found what everybody had already…
Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.
I would rather be corrected than agreed with, if it comes to it.
From the other side of the consultation, briefly.
Gallbladder ultrasound monitoring on gallbladder risk: given the known gallstone risk with rapid weight loss, my doctor orders gallbladder ultrasound every 6 months:
Baseline: normal, no stones or sludge
Month 6: small amount of biliary sludge, no stones
Month 12: sludge resolved, gallbladder normal
Ursodeoxycholic acid (Ursodiol) 300mg BID was prescribed prophylactically from the start. This reduces gallstone formation during rapid weight loss by ~60% per the available data. Ask your doctor about prophylactic ursodiol if you're losing weight rapidly.