Q: I would like to know how this high fat diet can work for those patients that do not have a gallbladder. Because they no longer have the concentrated enzymes needed to breakdown a high fat meal dose this change how they are or are not absorbing the fat. regardless of good or bad.
A: I address this question in my book, Primal Fat Burner at some length.
The fact that you don’t have a gallbladder can certainly be a bit of an issue, but is not an insurmountable problem when it comes to adopting this way of eating. You do have to take an extra step or two, however, to prepare for this dietary transition (which I still highly recommend). The first key consideration is that whatever the issues were that caused you to lose your gallbladder in the first place may very well still be problematic for you and didn’t go away simply because your gallbladder did. You need really to look at this closely.
Common reasons for gallbladder problems include thyroid issues, excessively low fat/vegetarian/vegan diets, diets overly high in processed fats/trans fats, and certain nutrient deficiencies. Also, I would recommend finding a quality source of bile salts you can used to supplement with fat-containing meals from now on to help enhance digestion and proper assimilation of quality fats, essential fatty acids, critical fat-soluble nutrients and dietary minerals. Whether you adopt my dietary approach or not (and I hope for your sake that you do), you absolutely have to find a way to better digest and absorb dietary fats. The minute trickle of bile directly into your small intestine from your liver (sans gallbladder) is simply not sufficient to prevent critical fat-soluble nutrient deficiencies down the road.
Bile salts, sometimes marketed as “ox bile” in health food stores, are composed of numerous substances typically produced by the liver and accumulated in the gallbladder for the express purpose of properly digesting fats and fat soluble nutrients. With no gallbladder, it becomes difficult to produce sufficient concentrations of bile salts on your own in order to meet the demand of a healthy diet (i.e., one that includes critical fats, essential fatty acids and fat-soluble nutrients– all of which are absolutely required for optimal brain, neurological and physiological health).
Most healthcare providers are able to get a hold of these through quality companies. With no gallbladder, I would be buying this stuff by the caseload, just to have it on hand. You might also want to consider a quality source of pancreatic enzymes rich in the enzyme, lipase to help a bit more with digestion and assimilation of critical fat-soluble nutrients. But if you had to pick one over the other (even though both would be nice)— for sure go for the bile salts. You will need to take these with every single fat-containing meal for the rest of your life in order to optimize your digestion of fats and fat-soluble nutrients going forward in the absence of a gallbladder.
PS. For those of you who still have a gallbladder: If you have gallbladder attacks or gallstones you should exercise extreme caution where increasing dietary fat is concerned and you may first need to resolve this issue with your trusted, licensed health care provider before embarking on any major dietary change. See my Disclaimer