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The following is a summary of “Long-term weight change patterns in American adulthood in relation to gallstones: evidence from NHANES,” published in the April 2025 issue of the BMC Gastroenterology by Chen et al.

This study investigates the relationship between longitudinal weight change patterns throughout adulthood and the risk of gallstone disease among middle-aged adults in the United States. By examining body weight status at key life stages and analyzing trends in weight gain or stability over time, the study aims to clarify how sustained obesity or changes in BMI may influence gallstone formation, a common gastrointestinal disorder with significant public health implications.

Data were drawn from the National Health and Nutrition Examination Survey 2017–2020, focusing on a representative sample of U.S. adults aged 40 to 70 years. Participants’ self-reported or recalled weights were used to classify BMI and determine weight status at three time points: age 25, ten years before the NHANES interview, and at the time of the interview. BMI categories included underweight, normal weight, overweight, and obese. Weight change patterns across the three periods (age 25 to 10 years before baseline, 10 years before baseline to baseline, and age 25 to baseline) were then categorized accordingly. Weighted logistic regression models were applied to estimate the ORs and 95% CIs for gallstone disease in relation to weight status and transition patterns, adjusting for relevant covariates. Subgroup analyses were conducted based on sex, diabetes status, and physical activity levels to assess effect modification.

Among participants, those who were classified as obese at age 25 exhibited a significantly increased risk of gallstone disease later in life compared to those with a normal BMI at that age (OR = 1.86, 95% CI: 1.07–3.24). Interestingly, weight status at baseline or ten years before baseline did not show a significant independent association with gallstone risk. When weight change patterns were considered, a consistent obese trajectory from age 25 to baseline was associated with nearly double the risk of developing gallstones (OR = 1.94, 95% CI: 1.03–3.65). A similar association was observed for participants who remained obese from age 25 to ten years prior to baseline (OR = 1.92, 95% CI: 1.05–3.49). However, weight change in the more recent decade (from ten years prior to baseline to baseline) was not significantly linked to gallstone prevalence. Stratified analyses suggested that the association between stable long-term obesity and gallstone risk was more pronounced in females, individuals with diabetes, and those reporting low physical activity, indicating potential vulnerability among these subgroups.

These findings underscore the importance of maintaining a healthy weight from early adulthood to reduce the risk of gallstone development later in life. Persistent obesity beginning in early adulthood appears to confer a significantly elevated risk, while more recent weight changes may not have the same impact. This highlights the long-term metabolic consequences of sustained obesity and supports early lifestyle interventions aimed at preventing or managing excess weight as a strategy for primary gallstone prevention.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-025-03846-7