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This is metabolic adaptation, and it is not a sign that your medication has stopped working

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[DOI] [PMC free article] [PubMed] [Google Scholar] 140.Trujillo-Alonso V, Pratt EC, Zong H, Lara-Martinez A, Kaittanis C, Rabie MO, Longo V, Becker MW, Roboz GJ, Grimm J, et al

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Holst et al., 1983

In this subgroup, a prophylactic cholecystectomy is advisable [120] Also, obese patients after gastric bypass surgery and during weight loss have increased mobilization of body cholesterol