Obesity and body fat distribution
Obesity is an important risk factor for gallstone disease, more so for women than for men. It raises the risk of cholesterol gallstones by increasing biliary secretion of cholesterol, as a result of an increase in 3-hydroxy-3-mthylglutaryl coenzyme A (HMGCoA) reductase activity. Epidemiological studies have found that the lithogenic risk of obesity is strongest in young women, and that slimness protects against cholelithiasis.[26]