Can Saxenda cause gallstones? This is an important question for anyone considering or currently using this weight management medication. Saxenda (liraglutide 3.0 mg) is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for weight management in adults with obesity or overweight with comorbidities. Whilst Saxenda can be highly effective in supporting weight loss, it is associated with an increased risk of gallbladder disease, including gallstone formation. This risk relates both to the rapid weight loss the medication facilitates and potentially to direct effects on gallbladder function. Understanding this risk, recognising symptoms, and knowing when to seek medical advice are essential for safe treatment.

Can Saxenda Cause Gallstones?

Saxenda (liraglutide 3.0 mg) is associated with an increased risk of gallbladder disease, including gallstones (cholelithiasis). This risk appears related to both the rapid weight loss it can facilitate and potentially to direct effects on gallbladder function. Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist licensed in the UK for weight management in adults with a body mass index (BMI) of 30 kg/m² or greater, or 27 kg/m² or greater with weight-related comorbidities. It works by mimicking the natural hormone GLP-1, which regulates appetite, slows gastric emptying, and enhances feelings of fullness, thereby reducing calorie intake.

Gallstones form when substances in bile—primarily cholesterol—crystallise within the gallbladder. Rapid weight loss is a significant risk factor for gallstone formation. When the body metabolises fat stores quickly, the liver secretes extra cholesterol into bile, whilst gallbladder motility may decrease, creating conditions favourable for stone formation. Additionally, GLP-1 receptor agonists like Saxenda may affect gallbladder emptying by influencing cholecystokinin release.

The Medicines and Healthcare products Regulatory Agency (MHRA) and the Saxenda Summary of Product Characteristics (SmPC) list cholelithiasis and cholecystitis as recognised adverse reactions. It is important to note that obesity itself is an independent risk factor for gallstones, and the overall health benefits of medically supervised weight loss typically outweigh this potential risk for most patients. However, the risk-benefit balance should be assessed individually by healthcare professionals. Patients prescribed Saxenda should be informed about gallstone symptoms and monitored appropriately throughout treatment, particularly during periods of rapid weight reduction.

Recognising Gallstone Symptoms While Taking Saxenda

Early recognition of gallstone symptoms is essential for anyone taking Saxenda, as prompt identification allows for timely medical assessment and management. Many people with gallstones remain asymptomatic, but when stones obstruct the bile ducts or cause gallbladder inflammation (cholecystitis), characteristic symptoms emerge.

The hallmark symptom is biliary colic—sudden, severe pain in the right upper quadrant or epigastrium (upper central abdomen) that may radiate to the right shoulder or between the shoulder blades. This pain typically:

• Develops rapidly and intensifies

• Lasts from 30 minutes to several hours

• Often occurs after eating, particularly fatty meals

• May be accompanied by nausea and vomiting

• Can cause restlessness and difficulty finding a comfortable position

Additional warning signs include:

• Jaundice (yellowing of skin and whites of eyes)

• Dark urine or pale, clay-coloured stools

• Fever and chills (suggesting infection)

• Persistent upper abdominal tenderness

• Indigestion, bloating, or intolerance to fatty foods

It is important to distinguish gallstone pain from common gastrointestinal side effects of Saxenda, which include nausea, vomiting, diarrhoea, and constipation. Saxenda-related nausea is typically most pronounced when initiating treatment or increasing the dose and usually improves over time, whereas biliary colic presents as severe, episodic pain with a distinct pattern.

If pancreatitis is suspected, stop Saxenda immediately and seek urgent medical attention. Patients should maintain awareness of gallstone symptoms throughout their Saxenda treatment, particularly during periods of rapid weight loss. Keeping a symptom diary can help identify patterns and facilitate discussions with healthcare professionals.

Reducing Your Risk of Gallstones on Saxenda

Whilst you cannot eliminate gallstone risk entirely, several evidence-based strategies can help minimise it during Saxenda treatment. The most important approach is achieving gradual, steady weight loss rather than rapid reduction.

Aim for a moderate rate of weight loss:

• Target 0.5–1 kg per week as recommended by NHS guidance

• Avoid very low-calorie diets (below 800 kcal/day) unless under specialist supervision as advised by NICE guidelines

• Work with a dietitian or healthcare professional to establish realistic goals

• Remember that Saxenda is designed to facilitate gradual, sustainable weight reduction

Maintain a balanced, nutritious diet that supports gallbladder health:

• Include adequate healthy fats in your diet—completely fat-free diets may impair gallbladder emptying

• Consume regular meals rather than skipping, as this promotes consistent gallbladder contraction

• Incorporate fibre-rich foods (vegetables, fruits, whole grains, legumes)

• Stay well-hydrated with water throughout the day

• Limit refined carbohydrates and added sugars

Physical activity plays a protective role against gallstone formation. The UK Chief Medical Officers recommend at least 150 minutes of moderate-intensity activity weekly, which not only supports weight management but also improves metabolic health and may enhance gallbladder motility.

Consider your individual risk factors and discuss them with your prescriber:

• Female sex, pregnancy history, and hormone therapy increase risk

• Family history of gallstones

• Rapid previous weight loss or bariatric surgery

• Certain medications (fibrates, oral contraceptives)

• Pre-existing conditions such as diabetes or Crohn's disease

For patients at particularly high risk, some specialists may consider ursodeoxycholic acid (UDCA). However, this is not routinely recommended for gallstone prevention during weight loss and would be an off-label use outside specialist settings such as certain bariatric surgery pathways. Your GP or weight management specialist can advise whether additional preventive measures are appropriate for your circumstances.

When to Seek Medical Advice

Knowing when to contact healthcare services is crucial for anyone taking Saxenda, as some gallstone-related complications require urgent assessment and treatment.

Seek immediate medical attention (call 999 or attend A&E) if you experience:

• Severe, persistent abdominal pain lasting more than a few hours

• Abdominal pain accompanied by high fever (above 38°C) or rigors

• Jaundice (yellowing of skin or eyes)

• Severe vomiting preventing fluid intake

• Signs of sepsis (confusion, rapid breathing, extreme weakness)

These symptoms may indicate acute cholecystitis (gallbladder inflammation), cholangitis (bile duct infection), or pancreatitis—all potentially serious complications requiring hospital assessment and treatment. If pancreatitis is suspected, stop taking Saxenda immediately.

Contact your GP within 24 hours if you notice:

• Recurrent episodes of right upper quadrant or epigastric pain

• Persistent nausea and vomiting beyond the usual Saxenda adjustment period

• New intolerance to fatty foods with associated discomfort

• Changes in stool colour (pale or clay-coloured) or dark urine

• Unexplained rapid weight loss

For urgent health concerns that aren't emergencies, NHS 111 can provide advice on whether and how quickly you need medical attention.

Routine monitoring and communication with your prescribing clinician is essential throughout Saxenda treatment. According to NICE guidance (TA664), treatment response should be assessed after 12 weeks on the 3.0 mg daily dose, and Saxenda should be discontinued if weight loss of at least 5% has not been achieved.

If gallstones are suspected, your GP will arrange appropriate investigations, typically starting with liver function tests and an abdominal ultrasound scan. Ultrasound is highly sensitive for detecting gallbladder stones and is recommended by NICE as the first-line imaging modality for suspected gallstones.

Treatment options for symptomatic gallstones range from conservative management and pain relief to surgical intervention (cholecystectomy). Your healthcare team will discuss whether to continue or pause Saxenda based on individual circumstances. Many patients can safely resume weight management treatment following gallstone treatment, though this decision should be made collaboratively with your specialist.

If you experience any suspected side effects from Saxenda, report them to the MHRA Yellow Card Scheme (search online for "MHRA Yellow Card"), which helps monitor medication safety in the UK.

Frequently Asked Questions