Funny thing about the gallbladder: If you don’t keep it busy squeezing out its bile contents into the bile duct and intestines to emulsify fats, bile can stagnate, a situation called “bile stasis.” Just as idle teenagers often get into trouble, so an idle gallbladder holding its bile contents develops bile stasis, the situation that allows bile crystallization that, over time, develops into gallstones.

In the Wheat Belly lifestyle, we keep our gallbladders very busy with unlimited intake of fatty meats, butter, coconut oil, olive oil, etc because fats:

  1. Do not cause heart disease
  2. Do not trigger formation of small LDL particles and liver de novo lipogenesis that creates most VLDL particles that lead to heart disease
  3. Are satiating and keep you from snacking or indulging in junk foods
  4. Stimulate release of cholecystokinin, CCK, that stimulates the gallbladder to contract and express its bile.

Recall that, in the Wheat Belly lifestyle, we also eliminate all grains and thereby sources of wheat germ agglutinin that would have blocked CCK. Yes: wheat and grains, by blocking CCK, contribute to bile stasis and gallstone formation.

You can therefore appreciate that the Wheat Belly lifestyle is, among numerous other health benefits, a gallbladder health program.

I’ve previously discussed how several clinical studies have now been conducted in which serial gallbladder ultrasounds have been performed in people embarking on a low-calorie and/or low-fat diet program. People are chosen at the start without gallstones. Surprisingly, many people (over 50% in some studies) develop gallstones, sometimes as quickly as four weeks after starting their diet program. Many go on to need gallbladder removal surgery, as illustrated in our recent survey. Not everybody, of course, develops gallstones, as there are other factors that weigh in such as the increased likelihood if you are female, older, and overweight.

Fat consumption is therefore necessary to not develop gallstones. The only downside to the Wheat Belly lifestyle is if you begin the program but already have gallstones, whether you are aware of them or not. When you convert from a low-calorie or low-fat lifestyle to an unlimited fat lifestyle, it can unmask the presence of gallstones when you begin to put your gallbladder to work more vigorously. This can bring out gallstone symptoms. Unfortunately, many people interpret this to mean that a higher fat intake causes gallstones. But you now know that it’s calorie and fat reduction that causes gallstones, an increase in fat intake that can simply unmask their presence.

Key takeaways: NEVER limit or count calories, NEVER limit fat. Enjoy healthy fats such as those in fatty cuts of meat, butter, coconut oil, and olive oil. But, should you develop symptoms of gallstones at the start of your Wheat Belly unlimited fat lifestyle, cut back on fat intake to minimize symptoms, then talk to your doctor about (prescription) ursodiol supplementation to encourage dissolution of the stones. Unfortunately, some people begin this program too far along with stones that are too big and cause cholecystitis and a surgical “solution” will be required.

Lastly, if you have gallstones, think long and hard about whether you also have SIBO, small intestinal bacterial overgrowth, as gallstones typically have colonic microorganisms in them—even though the gallbladder communicates via the bile duct with the duodenum, over 20 feet up from the colon.