Jump to: What is a gallbladder, and what does it do? | What is Mounjaro? | Safety considerations for taking Mounjaro without a gallbladder | Why take Mounjaro if you don’t have a gallbladder? | Managing Mounjaro side effects after gallbladder removal | Practical meal planning without a gallbladder | Frequently asked questions | Take home message
You can take Mounjaro if you don’t have a gallbladder and have a higher BMI. UK health guidance from NICE confirms that having your gallbladder removed (cholecystectomy) is not a contraindication for tirzepatide1.
In fact, Mounjaro may support health improvements associated with weight loss and could help prevent weight gain that sometimes occurs after gallbladder removal.
Gallbladder removal is a common procedure in the UK, with over 70,000 cholecystectomies performed annually2.
Research suggests that having your gallbladder removed can sometimes lead to weight gain post-surgery, with studies indicating many patients experience modest weight increases in the months following cholecystectomy3.
You won’t be prescribed Mounjaro if your BMI is below 27 (with weight-related health problems) or below 30 (without additional health problems), as it could lead to unnecessary weight loss.
The medication works the same way whether you have a gallbladder or not, though you may need to pay more attention to certain dietary considerations to manage digestive comfort.
Important safety information: Mounjaro (tirzepatide) is a prescription-only medication for treating type 2 diabetes and managing obesity. Always consult with your healthcare provider before starting any new medication, particularly if you have had your gallbladder removed or have other health conditions.
What is a gallbladder, and what does it do?
The gallbladder is a small, pear-shaped organ beneath the liver that plays a vital role in the digestive system.
Its main functions include:
- Storing and concentrating bile produced by the liver
- Releasing bile into the small intestine to help break down dietary fats
- Neutralising stomach acid during digestion
- Assisting in removing certain waste products from the body
How can we function without a gallbladder?
While the gallbladder has important functions, it isn’t essential for human life. After gallbladder removal:
- The liver continues to produce bile, but instead of being stored and concentrated, bile flows continuously into the digestive system
- Most people adapt to this change within a few months
- There’s no discernible difference in life expectancy between those who have a gallbladder and those who have had it removed4
- Some people experience digestive changes such as looser stools, especially after meals high in fat
People who’ve had a gallbladder removed may experience some gastrointestinal effects in the months following the operation.
Still, after adjusting their diet (like eating smaller, more frequent meals with moderate fat content), these symptoms typically improve.
What is Mounjaro?
Mounjaro (tirzepatide) is a dual-action weight-loss injection approved by NICE in 2023 for treating type 2 diabetes and in 2024 for managing obesity1,5. It works through two main ways:
- It mimics two hormones, GLP-1 and GIP, that communicate with the brain’s appetite control centre to reduce hunger and food cravings
- It slows down the rate of gastric emptying, helping you feel fuller for longer after meals
By reducing hunger and slowing digestion, Mounjaro helps create a calorie deficit, which occurs when you consume fewer calories than your body needs for essential functions. This deficit causes your body to use stored fat for energy, resulting in weight loss.
Randomised controlled trials have shown that Mounjaro leads to an average weight loss of around 26% after one year6. This makes it the most effective medication currently available for weight loss.
Safety considerations for taking Mounjaro without a gallbladder
| Consideration |
With gallbladder |
Without gallbladder |
| Fat digestion |
Bile is released in concentrated amounts after eating |
Continuous bile flow may be less effective at digesting large amounts of fat at once |
| Common side effects |
Nausea, constipation, diarrhoea |
Same side effects, but potentially more prone to diarrhoea with fatty meals |
| Dietary adjustments |
General healthy eating guidance |
May need smaller, more frequent meals with moderate fat content |
| Medication effectiveness |
Normal absorption and effectiveness |
No difference in effectiveness |
| Monitoring needs |
Standard monitoring |
May need more attention to digestive symptoms initially |
Clinical trials for Mounjaro did include participants without gallbladders, and no specific warnings or contraindications have been issued for this group7.
However, because both gallbladder removal and GLP-1 medications can affect digestive processes, being aware of potential considerations is necessary.
Why take Mounjaro if you don’t have a gallbladder?
There are several reasons why Mounjaro might be beneficial if you don’t have a gallbladder and have a higher BMI:
Preventing post-cholecystectomy weight gain
Research suggests that having your gallbladder removed can sometimes lead to weight gain. A study following patients after cholecystectomy found that many patients experience modest weight gain in the months following the procedure3.
The reasons for this weight gain may include:
- Changes in bile flow affecting fat metabolism
- Altered gut hormone signalling
- Reduced physical activity during recovery
- Changes in dietary habits after surgery
Taking Mounjaro could help counteract this tendency toward weight gain by reducing appetite and slowing digestion.
Addressing the obesity-gallstone connection
There’s a strong link between obesity and gallstone formation, which is the primary reason gallbladders are removed. There’s a strong association between higher BMI and gallstone formation, with obesity being one of the most significant risk factors for gallstone disease8.
By supporting significant weight loss, Mounjaro can help address one of the underlying factors that may have contributed to gallstone formation in the first place.
Improving metabolic health
Beyond weight loss, Mounjaro has been shown to improve several aspects of metabolic health, including:
- Better blood sugar control
- Reduced inflammation
- Improved cardiovascular risk factors
- Decreased liver fat
These benefits are valuable regardless of gallbladder status and can help reduce the risk of other weight-related health complications.
Managing Mounjaro side effects after gallbladder removal
People without a gallbladder may need to be particularly mindful of digestive side effects when taking Mounjaro. Here are strategies to help manage potential issues:
For nausea and vomiting
-
- Eat smaller meals based on whole foods more frequently throughout the day (3 main meals with 2 snacks)
- Minimise ultra-processed food consumption
- Stay well hydrated between meals (not during meals)
- Consider ginger tea or supplements, which have shown effectiveness for nausea
- Avoid lying down for at least an hour after eating
For diarrhoea or loose stools
- Limit foods high in fat, particularly in the early stages after gallbladder removal
- Introduce fat gradually into your diet to allow your system to adjust
- Consider soluble fibre supplements like psyllium husk
- Stay well hydrated to replace lost fluids
- Speak to your healthcare provider about bile acid sequestrants if diarrhoea persists
For constipation
- Ensure adequate fibre intake from vegetables, fruits, and whole grains
- Stay well hydrated throughout the day
- Maintain regular physical activity
- Consider a magnesium supplement (300-400 mg daily)
- Establish a regular bathroom routine
Most side effects tend to improve over time as your body adjusts to the medication. Research shows that most side effects tend to diminish over time with proper support9.
Practical meal planning without a gallbladder
Following the Second Nature balanced plate model works well for people on Mounjaro without a gallbladder, with some specific considerations:
- Protein (25% of your plate): Focus on lean protein sources that are easier to digest, such as chicken, fish, eggs, tofu, and low-fat dairy
- Vegetables (50% of your plate): Emphasise non-starchy vegetables for fibre and nutrients without adding digestive stress
- Complex carbohydrates (25% of your plate): Choose whole grains like brown rice, quinoa, and oats for sustained energy
- Fats: Distribute fat intake throughout the day rather than consuming it all at once; focus on easier-to-digest fats like olive oil, avocado, and nuts in moderate amounts
Sample meal ideas for Mounjaro users without a gallbladder:
Breakfast options:
- Greek yoghurt with berries and a handful of nuts or peanut butter
- Scrambled eggs (3 eggs) with spinach and a small amount of feta cheese
- Overnight oats made with almond milk and a teaspoon of nut butter
Lunch options:
- Grilled chicken salad and avocado salad with an extra olive oil dressing
- Quinoa bowl with roasted vegetables and a portion of salmon
- Lentil soup and 3 boiled eggs with a slice of wholegrain bread
Dinner options:
- Baked white fish with steamed vegetables and a small portion of brown rice
- Turkey stir-fry with plenty of vegetables and a small amount of olive oil
- Vegetable and bean chilli with a dollop of plain yoghurt
Snack options:
- Apple slices with a teaspoon of nut butter
- Small handful of unsalted nuts
- Carrot sticks with a tablespoon of hummus
- Hard-boiled eggs
- Tinned fish
- Cured meats
Frequently asked questions
Will Mounjaro cause more digestive issues if I don’t have a gallbladder?
Not necessarily. While both gallbladder removal and Mounjaro can affect digestion, there’s no evidence that combining them significantly increases digestive issues.
However, you may need to be more mindful of fat intake and meal timing. Start with smaller, more frequent meals with moderate fat content, and gradually adjust as your body adapts to the medication.
How long after gallbladder removal can I start Mounjaro?
Most healthcare providers recommend waiting until you’ve fully recovered from gallbladder surgery before starting Mounjaro, typically at least 4-6 weeks.
This allows your digestive system to adjust to functioning without a gallbladder. Always follow your surgeon’s and prescribing clinician’s specific guidance.
Can Mounjaro help with digestive issues after gallbladder removal?
Mounjaro isn’t prescribed explicitly for post-cholecystectomy digestive issues. However, by slowing gastric emptying, it might help some people better tolerate meals since food enters the small intestine more gradually.
If you’re experiencing significant digestive issues after gallbladder removal, speak to your healthcare provider about specific treatments.
Should I take digestive enzymes with Mounjaro if I don’t have a gallbladder?
Digestive enzymes aren’t routinely recommended for everyone without a gallbladder. However, if you experience significant digestive discomfort with fatty meals while on Mounjaro, your healthcare provider might suggest trying digestive enzyme supplements. These could help with fat digestion when your continuous bile flow isn’t sufficient.
Will I lose weight faster on Mounjaro without a gallbladder?
There’s no evidence suggesting that not having a gallbladder increases or decreases the effectiveness of Mounjaro for weight loss.
The medication works primarily by affecting appetite signals in the brain and slowing gastric emptying, mechanisms that don’t depend on gallbladder function.
Can I get Mounjaro on the NHS if I don’t have a gallbladder?
Having your gallbladder removed doesn’t affect NHS eligibility for Mounjaro. The primary criteria relate to your BMI (≥35 with weight-related health conditions, or ≥30 in some cases) and previous weight loss attempts.
As of October 2024, access to Mounjaro on the NHS remains limited as implementation plans are still being developed following NICE approval.
How should I time my meals while on Mounjaro without a gallbladder?
Without a gallbladder, many people find that smaller, more frequent meals are easier to digest. Mounjaro slows digestion, which might actually help regulate the continuous flow of bile.
Consider eating 4-6 smaller meals throughout the day rather than 3 larger ones, and allow 3-4 hours between meals for comfortable digestion.
Take home message
You can safely take Mounjaro if you don’t have a gallbladder and have a higher BMI. The medication works through mechanisms that don’t depend on gallbladder function and may help prevent the weight gain that sometimes occurs after gallbladder removal.
While both gallbladder removal and Mounjaro can affect digestion, with some dietary adjustments – like eating smaller, more frequent meals with moderate fat content – most people can manage comfortably on the medication.
The combination of Mounjaro’s appetite-suppressing effects and a mindful approach to nutrition can support significant weight loss and improved metabolic health, regardless of whether you have a gallbladder or not.
As with any medication, working closely with your healthcare provider to monitor your progress and address any concerns is essential for the best results.
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
References
- National Institute for Health and Care Excellence. (2025). Tirzepatide for managing overweight and obesity (TA1026)
- NHS Digital. (2023). Hospital Admitted Patient Care Activity, 2022-23
- Ali, B.R., et al. (2004). Weight Gain After Cholecystectomy. Irish Journal of Medical Science, 173, 9-12.
- Carraro, A., et al. (2011). Health-related quality of life outcomes after cholecystectomy. World Journal of Gastroenterology, 17(45), 4945-4951.
- National Institute for Health and Care Excellence. (2023). Tirzepatide for treating type 2 diabetes (TA924)
- Jastreboff, A.M., et al. (2022). Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine, 387(3), 205-216.
- Medicines and Healthcare products Regulatory Agency. (2025). Drug Safety Update: Tirzepatide (Mounjaro): monitoring and management of gastrointestinal adverse effects
- Di Ciaula A, Wang DQ, Portincasa P. (2018). An update on the pathogenesis of cholesterol gallstone disease. Current Opinion in Gastroenterology, 34(2), 71-80.
- Richards, R., et al. (2025). A Remotely Delivered, Semaglutide-Supported Weight Management Program: 12-Month Outcomes From a Retrospective Service Evaluation. JMIR Formative Research, 9(1), e72577.
