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When you combine thicker bile with a gallbladder thats not emptying well, you start seeing more gallbladder attacks. A meta-analysis of 76 randomized clinical trials found that the risk of gallbladder problems increases when weight-loss medications are used at higher doses and for longer durations

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NICE recommends considering surgery for adults with BMI 35 kg/m (with lower thresholds for people from Black African, African-Caribbean, South Asian, and Chinese family backgrounds) and recent-onset type 2 diabetes