Current guidance uses an individualized assessment
The American Society of Anesthesiologists’ patient guidance and 2024 multisociety statement say most patients can continue GLP-1 medicines before elective procedures. They also identify circumstances requiring additional planning. An old blanket instruction to hold every weekly dose is not the whole current recommendation.
Tell the surgical or endoscopy team that you take the medicine when the procedure is scheduled. Give the exact product, dose schedule, most recent dose and reason for treatment. Do not wait until the day of the procedure to mention it.
Sources: Drugs for Diabetes or Weight Loss: What To Know Before Surgery · New Multi-Society GLP-1 Clinical Practice Guidance Released
Stomach emptying is the concern behind the discussion
The guidance explains that delayed stomach emptying can leave stomach contents present during general anesthesia or deep sedation, raising aspiration concerns. Risk assessment is about the specific procedure and patient, rather than a statement that every GLP-1 user has the same risk.
Mention nausea, vomiting, constipation, abdominal symptoms and any other condition that affects stomach emptying. Ask who will coordinate the decision between the procedure team, anesthesiologist and clinician managing the medicine.
Sources: Drugs for Diabetes or Weight Loss: What To Know Before Surgery · New Multi-Society GLP-1 Clinical Practice Guidance Released
Starting or increasing treatment can change the plan
The multisociety guidance highlights escalation, significant gastrointestinal symptoms, higher doses and other conditions slowing gastric emptying. Depending on the assessment, the team may advise a temporary liquid-only plan, alter anesthesia precautions, use additional assessment or delay an elective procedure.
Those measures are selected by the care team. Do not choose your own fasting duration, stop another diabetes medicine or assume a liquid diet guarantees that the procedure can proceed. Ask for the instructions that apply to your appointment.
Sources: New Multi-Society GLP-1 Clinical Practice Guidance Released · Drugs for Diabetes or Weight Loss: What To Know Before Surgery
Get one clear set of written instructions
Ask which medicines to continue or hold, what to eat and drink, when fasting begins and what symptoms require a call. If instructions from separate offices conflict, request that they be reconciled before changing treatment.
Include a plan for the period after the procedure: who decides when treatment resumes, whether an interruption requires reassessment, and how to handle a refill. A procedure-specific instruction is not a permanent change to your GLP-1 regimen.
Sources: Drugs for Diabetes or Weight Loss: What To Know Before Surgery · Wegovy prescribing information · Zepbound prescribing information
Urgent care should not wait for an elective checklist
In an emergency, promptly tell the team what you take and when you last took it. The ASA patient guidance describes anesthesia precautions for urgent surgery; the treating team decides how to proceed.
For elective care, advance communication gives the team time to plan. Keep your medication list and pharmacy details available, and bring any written instructions to the procedure appointment so that the final review uses the same information.
Sources: Drugs for Diabetes or Weight Loss: What To Know Before Surgery