Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Mostly true Scientifically well supported Certainty of evidence: moderate provisional C-BAR-11

Sleeve gastrectomy causes gallstones (stones form faster after sleeve/rapid weight loss).

In short: This claim is correct in substance: rapid weight loss after sleeve gastrectomy often leads to gallstones (about one in five without prevention in an Egyptian trial), although not every patient is affected and preventive medication reduces the risk by about 70%.
Conclusion: Correct: gallstones are a recognized consequence of sleeve and rapid weight loss.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

وانت تخين وخسيت بيجي لك حصوه وانت عامل تكميم بيجي لك الحصوه اسرع

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Sleeve gastrectomy causes gallstones (stones form faster after sleeve/rapid weight loss).

Origin

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr.D Clinics - Diaa Al Awady is live!ايه هو ال HDL⧸ LDL⧸ Chylomicrons (Open source)
Published
5 April 2025
Timestamp
0:25:45 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Claimed mechanism

Rapid weight loss after sleeve.

Claimed health effect

Gallstones.

Population concerned

Sleeve patients

Geographic restriction by Elawady

none found

Diverging source versions

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
اتفرجوا عالبودكاست ده وقولولي رأيكوا عشان انزلكوا الحلقه التانيه منه (Open source)
Published
9 April 2026
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
الخوف حقيقه ام سراب. أضرار التكميم. بين الحقيقه والسراب (Open source)
Published
19 November 2025
Timestamp
not available (transcript has no timings)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.

Scientific assessment

Mostly true – Correct at its core, but with limitations or minor inaccuracies.

Certainty of evidence: moderate – Further research may still affect the assessment.

1. What was claimed?

Gallstones after sleeve.

2. What is demonstrably correct?

Correct: gallstone formation after bariatric surgery, including sleeve, is a recognized complication; UDCA prophylaxis reduced gallstone formation (OR 0.25), symptomatic disease (OR 0.29) and cholecystectomy (OR 0.33) in RCTs including sleeve patients (I-BAR-12).

3. What is wrong or exaggerated?

'Always' (دايما) overstates it; many patients do not form stones.

4. What remains unclear?

Exact incidence after sleeve compared with equal non-surgical weight loss; the Egyptian trial abstract contains internally inconsistent numbers.

5. Which studies support it?

I-BAR-12; Egyptian RCT (I-BAR-136): gallstones in about 22% within a year without prophylaxis vs 6.5% with UDCA; most stone formers had sleeve.

6. Which studies contradict it?

None against the direction; gallstone risk after sleeve is not higher than after bypass (I-BAR-137).

7. What applies to Germany and Europe?

Most key data are European (Sweden SOS/SOReg, Finland SLEEVEPASS, Switzerland SM-BOSS). European and international society guidelines consider bariatric surgery for severe obesity with lifelong follow-up.

8. What is known about Egypt?

No Egypt-specific outcome data were identified in this review. Elawady states in a transcript that sleeve gastrectomy is very widely performed in Egypt ('مصر كلها بتعملها'); the procedure-specific risks (reflux, deficiencies) apply wherever it is performed, and follow-up quality (supplements, endoscopy, mental-health screening) determines part of the risk.

9. What practical conclusion is appropriate?

Gallstone prevention is part of bariatric aftercare in many centres.

Assessment details

Rationale for certainty of evidence

Gallstone formation after bariatric surgery (including sleeve) is established enough that 11 RCTs tested and confirmed prevention with UDCA.

Source quality

Elawady's statement matches established surgical knowledge.

Regional transferability

Applicable.

Individual exceptions

Not every patient forms stones; UDCA prophylaxis reduces risk by about 75%.

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

Scientifically well supported – The claim agrees with consistent, high-quality evidence.

Research question: Does sleeve gastrectomy (via rapid weight loss) increase gallstone formation?

Research question in detail (PICO)
Population
Adults after sleeve gastrectomy
Intervention or exposure
Sleeve gastrectomy / rapid weight loss
Comparison
Placebo prophylaxis arm; bypass; non-surgical weight loss
Geographic scope
universal biology
Outcomes
  • Incident gallstones
  • Symptomatic gallstone disease
  • Cholecystectomy

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Gallstones commonly form after sleeve and other bariatric operations because of rapid weight loss; not everyone is affected and prophylaxis prevents most.

Why some studies weigh more

RCT placebo arms give direct incidence; meta-analysis of RCTs shows preventability.

Is a causal relationship established? Yes, established Rapid weight loss is a known cause of cholesterol gallstones.

Remaining uncertainty

Exact sleeve incidence vs equal non-surgical weight loss.

Justified conclusion

Correct; "always" overstated.

Why do studies seem to disagree?

Sleeve vs bypass comparisons are inconsistent and sensitive to one large study; both procedures raise risk.

Does this depend on the country?
General biological effects
Universal.
Eating habits
Not applicable (surgical procedure, not a food).
Origin of the food
Not applicable (surgical procedure, not a food).
Contaminants
Not applicable (surgical procedure, not a food).
National production conditions
Not applicable.
Legal rules
Not applicable.
Actual monitoring data
Egyptian RCT (I-BAR-136) directly relevant.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • ARR/NNT and internal consistency – ARR 15.5 points, NNT 6.5 (reported 6); overall incidence 9.7% inconsistent with arm rates unless groups very unequal; "RR is 3.4%" invalid. recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Gallstone formation after sleeve/rapid weight loss
Starting level
high (randomised trials)
Reasons for downgrading
  • indirectness (mixed procedures)
Result
moderate

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
Europe PMC26 October 2026(TITLE:"gallstone*" OR TITLE:"cholelithiasis" OR TITLE:"cholecystectomy" OR TITLE:"gallbladder") AND (TITLE:"sleeve gastrectomy" OR TITLE:"bariatric") AND (PUB_TYPE:"Meta-Analysis" OR TITLE:"meta-analysis" OR TITLE:"incidence" OR TITLE:"nationwide" OR TITLE:"randomized") AND PUB_YEAR:[2017 TO 2026]both directions43
PubMed26 October 2026(gallstone*[ti] OR cholecystectomy[ti] OR gallbladder disease[ti]) AND (bariatric[ti] OR obesity surgery[ti] OR sleeve gastrectomy[ti]) AND (controls OR nonoperated OR non-operated OR matched OR Swedish Obese Subjects)supporting evidence46

Open questions

Sleeve-specific incidence in Egypt with ultrasound follow-up.

How deeply was this checked?

3 linked studies: 0 checked in full text (0 of them with a structured risk-of-bias assessment), 3 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: Mostly true (moderate)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: Mostly true (moderate)
    Unchanged (“Mostly true”, moderate). Egyptian RCT adds direct regional incidence data.
    New sources: I-BAR-136 I-BAR-137

In plain language

Elawady said that gallstones form faster after sleeve gastrectomy. This is correct. Rapid weight loss after surgery makes gallstones more likely, and trials show that a bile-acid medicine can prevent many of them. Not every patient gets stones, however.

Studies on this claim

Studies supporting the claim (2)

  • Preventing gallstones after weight-loss surgery

    Mulliri A et al.. J Gastroenterol 2022 · PMID 35704084 · DOI 10.1007/s00535-022-01886-4
    Meta-analysisindependent cross-checkabstract checked

    A bile-acid drug cut new gallstones by about 75% after surgery, including sleeve.

    Sleeve gastrectomy causes gallstones (stones form faster after sleeve/rapid weight loss).

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Gallstone prevention

    How was the study done?

    Meta-analysis of RCTs

    How many people, animals or samples were studied?

    3474

    What was actually found?

    UDCA effective

    How large was the observed effect?

    OR 0.25

    What do the results mean in everyday life?

    Gallstones after surgery are expected and preventable

    What are the study's limitations?

    Incidence not in abstract

    What does it say about Elawady's specific claim?

    Supports that sleeve can lead to gallstones

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Absolute risk

    Scientific details →

  • Egyptian trial: gallstones after obesity surgery

    Talha et al.. Surg Endosc 2020 · PMID 31858245 · DOI 10.1007/s00464-019-07323-7
    Randomised controlled trialindependent cross-checkabstract checked★ key study

    Without preventive medicine, about 22 in 100 patients formed gallstones within a year; a bile-acid medicine lowered this to about 6 in 100.

    Gallstones in 22% without prophylaxis; most stone formers had SG.

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Gallstones and UDCA

    How was the study done?

    RCT

    How many people, animals or samples were studied?

    1,432

    What was actually found?

    22% vs 6.5%

    How large was the observed effect?

    NNT 6

    What do the results mean in everyday life?

    Gallstones are common after rapid weight loss and largely preventable

    What are the study's limitations?

    Inconsistent numbers in abstract

    What does it say about Elawady's specific claim?

    Supports the claim

    Do the results apply to Germany and Europe?

    Egypt

    What can explicitly not be concluded from this study?

    Exact sleeve rate

    Scientific details →

Studies contradicting or limiting the claim (0)

No studies in this group.

Studies with mixed or unclear results (1)

  • Meta-analysis: gallstones after sleeve vs bypass

    Silva-Chavez et al.. Obes Surg 2025 · PMID 41251897 · DOI 10.1007/s11695-025-08388-1
    Meta-analysisindependent cross-checkabstract checked

    Gallstones formed after both operations; in the short term they were somewhat less common after sleeve.

    Gallstones after both; SG not higher than RYGB (OR 0.68, fragile).

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Gallstones SG vs RYGB

    How was the study done?

    Meta-analysis

    How many people, animals or samples were studied?

    195,665

    What was actually found?

    OR 0.68

    How large was the observed effect?

    OR 0.68

    What do the results mean in everyday life?

    Both operations raise gallstone risk

    What are the study's limitations?

    Fragile

    What does it say about Elawady's specific claim?

    Partly supports

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Risk vs no surgery

    Scientific details →

Regional context

Germany / EU

Most key data are European (Sweden SOS/SOReg, Finland SLEEVEPASS, Switzerland SM-BOSS). European and international society guidelines consider bariatric surgery for severe obesity with lifelong follow-up.

Egypt

No Egypt-specific outcome data were identified in this review. Elawady states in a transcript that sleeve gastrectomy is very widely performed in Egypt ('مصر كلها بتعملها'); the procedure-specific risks (reflux, deficiencies) apply wherever it is performed, and follow-up quality (supplements, endoscopy, mental-health screening) determines part of the risk.

What applies in my country?

General scientific assessment

Mostly true Correct: gallstones are a recognized consequence of sleeve and rapid weight loss.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Ursodeoxycholic acid for the prevention of gallstones and subsequent cholecystectomy after bariatric surgery: a meta-analysis of randomized controlled trials.. Mulliri A et al.. J Gastroenterol 2022 · PMID 35704084 · DOI 10.1007/s00535-022-01886-4
  2. Cholelithiasis after bariatric surgery, incidence, and prophylaxis: randomized controlled trial.. Talha et al.. Surg Endosc 2020 · PMID 31858245 · DOI 10.1007/s00464-019-07323-7
  3. Comparative Risk of Gallstone Formation After Sleeve Gastrectomy and Roux-En-Y Gastric Bypass: A Systematic Review and Meta-Analysis.. Silva-Chavez et al.. Obes Surg 2025 · PMID 41251897 · DOI 10.1007/s11695-025-08388-1

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