jason_paloalto said:

Lost weight quickly, developed right-upper-quadrant pain after fatty meals, and ended up having an ultrasound that found what everybody had already…

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.

DataDave said:

Gallbladder ultrasound monitoring on gallbladder risk: given the known gallstone risk with rapid weight loss, my doctor orders gallbladder ultrasound…

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 8 — it was full of stones. My surgeon said it's very common in significant weight loss patients.

jason_paloalto said:

Lost weight quickly, developed right-upper-quadrant pain after fatty meals, and ended up having an ultrasound that found what everybody had already…

Can confirm. Same sequence, different timescale.

Clinical perspective, offered as context rather than as advice. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.