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Types and risk factors Understanding gallstone types helps predict risk and management strategies: How Mounjaro affects gallbladder function Clinical trial data on gallbladder events The SURMOUNT clinical trials provide comprehensive safety data on Mounjaros gallbladder effects 1 : SURMOUNT-1 findings: Gallbladder-related adverse events: 0.6% (Mounjaro) vs 0% (placebo) Most events were cholelithiasis (gallstones) or cholecystitis Higher doses (10 mg, 15 mg) showed a slightly higher risk than 5 mg Most events occurred within the first 20 weeks of treatment Severity of events: Mild to moderate: 85% of cases Severe: 15% of cases Led to treatment discontinuation: 2 cm) Porcelain gallbladder Concurrent liver disease Pre-treatment screening NICE guidelines dont mandate gallbladder screening before starting GLP-1 medications 5 , but consider assessment if: High-risk patients: Previous gallstone symptoms Multiple risk factors present Strong family history Previous rapid weight loss attempts Screening options: Detailed history and examination Liver function tests (may be elevated with gallstones) Ultrasound scan if clinically indicated Risk stratification *Monitoring frequency represents expert practice suggestions rather than mandated protocol

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Greater weight loss efficacy of tirzepatide 10 mg ( 3.2 kg) and 15 mg ( 5.2 kg) compared to semaglutide was also observed in an indirect comparison with data from the SUSTAIN FORTE study, where semaglutide was administered at the maximum hypoglycemic dose of 2.0 mg [49]