'So either Actigall didn't work as a preventative, or I was on the placebo or the reduced dose. '
I'm reading your post and wondering what you think of that yourself. I know I went to NCBI and looked up Actigall myself!
The fact that gallstones (obviously not all gallstones) develop over several years suggests screening for gallstones before going on a 'liquid, ultra low-calorie, ultra low-fat diet,' is probably a very good idea. WW is none of those things, though.
You developed gallstones after four months.
'So either Actigall didn't work as a preventative, or I was on the placebo or the reduced dose. At any rate I was given a prescription for a free year's supply of Actigall to dissolve the stones, and I never had a gallbladder problem again' (It does seem like the milk thistle keeps that under control. What would happen if you didn't take the milk thistle? I have no qualms about the use of milk thistle. I have some myself, although I never actually used it!)
From what you say, it could be that you were on the placebo or reduced dose. And in four months of the diet (fiber free? should I be able to guess that?), taking Actigall didn't act as a preventative. That seems clear! For other people in the trial, did it prevent gallstones for them? What were the results of the trial?
A recent review of what's known about gallstone prevention referred to several factors. One was 'rapid weight loss'; could that have been the case for you? This abstract has the summary:
http://www.ncbi.nlm.nih.gov/pubmed/17127188
This study, produced in 1993, is about 'Gall Stone Formation and Weight Loss' too:
http://www.ncbi.nlm.nih.gov/pubmed/16350561
It says:
'Despite the potential health benefits of weight reduction, very-low-calorie diets appear to increase the risk for cholesterol crystal and gallstone formation. The incidence of gallstone formation seems to be dependent on the degree of caloric restriction, the rate of weight loss, and the duration of the dietary intervention. Thus, faster rates of weight loss for longer periods of time are associated with increased risk. Available data obtained from prospective studies of subjects during active weight loss suggest that newly formed gallstones occur within 4 weeks and with incidence rates 15 to 25-fold higher than in the general obese population.'
'But it all began with the super-low-fat Medifast diet. The doctors running the study said that gallstones are a classic side effect of very low fat eating.'
(Very low-fat eating would cause rapid weight loss, right? But then, fasting would also cause that. And possibly, any other diet that worked quicky if you adhered to it and lost weight quickly. Atkins, even. One thing WW tells its members is that there is a pace of weight loss that is more healthy, and that is 1-2 pounds a week. My doctor agrees.)
If those doctors, in the 90s, said that about diet and gall stones, then I'm wondering why the studies have not shown that. Did you read the article that gave a 2004 review of the factors for gallstone formation (from studies), 'Diet as a Risk Factor for Gall Stone Disease'?
As I've said in other posts, I lost 20 pounds in the 80s, on a supervised (but not liquid, however 'ultra-calorie') diet that required daily meetings with a counselor to discuss my food intake. The company went out of business and I never knew why. Since they had to have a doctor on site at the center, you had to have a doctor's approval to start (who would send anyone to such a plan if it was guaranteed to produce gallstones?) and they had to have nurses and diet counselors to spend time with all the people on the diet, reporting in every day! Overhead-heavy, I would say. It was a 700-calorie-a-day diet and I managed it quite well after the shock of the first weeks. I was not anywhere near the weight I am today. I kept the weight off until after the birth of my first child.
And I never got gallstones. I also have had ultrasounds that detected fatty liver disease but never gallstones but then, again, I don't know how closely they look for that.
That's MY experience being a human guinea pig for gall stones. It could be that the 200 calories more on my diet made all the difference. The WW diet, with points, or without, does not tell you to eat that level of calories (points are assigned according to your weight and the more you weigh, the more points you get. As you lose weight, your points are adjusted downward - and not right away, either!)
But - most importantly - I'm still trying to find out what the 'lithogenic diet' for gallstones is. So far, it looks like feeding mice 1% cholesterol and 0.5% cholic acid, added to their normal pellet chow,produces gallstones. I don't think that is low fat.
That lithogenic diet:
http://www.ncbi.nlm.nih.gov/pubmed/10402171
If anything, look to a liquid diet - this particular study did:
http://www.ncbi.nlm.nih.gov/pubmed/7489033
The authors say:
'Results of this study indicate that an increased risk of gallstones is not limited to very-low-calorie diets and that the incidence of this complication should be assessed in persons who consume popular over-the-counter meal replacement plans.' (Published in 1995. I'm pretty sure the doctors from your Actigall study would design their study differently, given the passage of those few years' time.. maybe the Actigall study produced useful data about the dangers of a liquid diet - it wouldn't be the first time.)
Actigall stuff:
http://www.ncbi.nlm.nih.gov/pubmed/10148919
http://www.ncbi.nlm.nih.gov/pubmed/2031947
http://www.ncbi.nlm.nih.gov/pubmed/8323995
The study that followed around 80,000 nurses for four years, 'Weight, diet, and the risk of symptomatic gallstones in middle-aged women.' tracked them for 4 years. From the abstract:
'Overall, we observed a roughly linear relation between relative weight and the risk of gallstones. Among the 59,306 women whose relative weight was less than 25 kg per square meter, a high energy intake (greater than 8200 J per day), as compared with a low energy intake (less than 4730 J per day), was associated with an increased incidence of symptomatic gallstones (relative risk, 2.1; 95 percent confidence interval, 1.4 to 3.3), and an alcohol intake of at least 5 g per day was associated with a decreased incidence as compared with abstention'
http://www.ncbi.nlm.nih.gov/pubmed/2761600
There were letter to the editors after the study was published in NEJM. The letter, of which, some basically said, 'You forgot about hormones!' In particular, 'parity' (having had children). The authors wrote a reply to the letters, which challenged that the important factors of parity, moderate alcohol use and age were not given more weight.