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According to FDA prescribing information, gallbladder-related adverse events occurred in clinical trials of semaglutide for weight management (Wegovy) at rates of 2.5% versus 1.0% with placebo, and for tirzepatide (Zepbound) at rates of 2.5% versus 1.0% with placebo

Reduced contraction frequency means bile sits for longer in the gallbladder a state called bile stasis giving cholesterol crystals the time and conditions to coalesce into solid stones

651-659 Campinas Sept./Oct

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Because semaglutide is a peptide (aka a small protein), the stomach is naturally programmed to digest it like food