Semaglutide and gallbladder disease risk — my results so far

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".

Dr.NutriCornell said:

The dose-response is real but shallow at the top.

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.

Correct me if the detail matters more than I have assumed.

lisa_labSD said:

Lost weight fast on purpose and now have intermittent right-sided pain after meals.

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

Adding the clinical framing, because it changes how the question reads.

Gallbladder warning for gallbladder risk: rapid weight loss increases gallstone risk regardless of method. GLP-1 patients have a ~2-3% incidence of gallbladder events in clinical trials.

Symptoms to watch for: pain in upper right abdomen after fatty meals, nausea after eating, pain radiating to right shoulder. I had my gallbladder out at month 5 — it was full of stones. My surgeon said it's very common in significant weight loss patients.