Drugs for Diabetes or Weight Loss: What To Know Before Surgery

Medically reviewed by Girish P. Joshi, MBBS, MD, FASA, October 22, 2025

GLP-1 Agonist Medications for Diabetes or Weight Loss

Certain types of medications taken for weight loss or diabetes management can affect the safety of patients when they undergo general anesthesia or deep sedation. Most patients can keep taking the drug as usual before their surgery or procedure, but there are things every patient should do to stay safer. Learn how to protect yourself, including making sure your anesthesiologist knows you’re using these medications.

Why should I discuss GLP-1 medications with the anesthesiologist before surgery?

To stay safer in surgery, always tell your surgical team and anesthesiologist about GLP-1 agonist medications you are taking, as well as all other medications and supplements. This includes making sure they know if you are taking a GLP-1 drug in combination with a glucose-dependent insulinotropic polypeptide (GIP) medication.

Whether taken alone or in combination, GLP-1 drugs can raise certain types of risks in surgery. Anesthesiologists cannot take special steps to protect you from these risks if they don’t know that you’re taking the medication. Before your surgery or procedure, they should talk to you about these risks and the options for reducing them.

Your surgical team and anesthesiologist also need information about all your medications and supplements so they can better prepare for any complications that may arise during surgery.

Which diabetes and weight loss drugs might increase my risks in surgery?

Medications that are classified as glucagon-like peptide-1 (GLP-1) receptor agonists might increase surgical risks for patients who are receiving general anesthesia or deep sedation. The generic versions of these drugs include dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide, and tirzepatide. Many of the brand names of these drugs are listed below:

Adlyxin^®
Bydureon BCise^®
Byetta^®
Mounjaro^®
Ozempic^®
Rybelsus^®
Saxenda^®
Trulicity^®
Victoza^®
Wegovy^®
Zepbound^®

How could GLP-1 agonist drugs affect my anesthesia and safety in surgery?

Medications like Ozempic, Wegovy, Mounjaro, Trulicity, Rybelsus, and others can delay the time it takes for food to empty from your stomach. In medical terminology, this is called “gastric emptying.” Patients who have food in their stomach while undergoing general anesthesia or deep sedation for surgery are at increased risk for a potentially serious complication.

Why would having food in your stomach make you less safe? Because your stomach contents could flow backward into your esophagus and get into your airway or lungs. This is called “regurgitation” and “aspiration.” Prevention of regurgitation and aspiration is why all patients are told to fast before any procedure that requires general anesthesia or sedation.

Aspiration of stomach contents into the lungs is dangerous and can be life-threatening. There are ways for the Anesthesia Care Team to respond to regurgitation and aspiration during surgery to try to protect the patient, but the safest option is to prevent it from occurring.

Do I need to stop taking drugs like Ozempic, Wegovy, or Mounjaro before surgery?

Most of the time, you can keep taking your GLP-1 medication as usual before surgery, according to guidance issued in 2024 by the American Society of Anesthesiologists, the American Gastroenterological Association, the American Society for Metabolic and Bariatric Surgery, the International Society of Perioperative Care of Patients with Obesity, and the Society of American Gastrointestinal and Endoscopic Surgeons.

In their guidance document, these groups advise that you consult with your anesthesiologist, surgeon, and the physician who prescribes your medication about how to manage your use of the medication before surgery. The goal is to ensure that you can have surgery safely without removing the benefit of your medication any longer than necessary.

In deciding how to proceed, you and your health care team will need to balance the potential benefit of delaying a dose with the potential risks. For example, if you’re taking the medication to manage your diabetes, temporarily withholding the drug could raise your blood sugar level. High blood sugar raises the level of risk in surgery.

What steps can be taken to reduce my risk without stopping my GLP-1 medication?

These are some actions your anesthesiologist can take to reduce your risk:

Instruct you to avoid eating solid food for 24 hours before surgery, which is longer than patients are usually told to stop eating before surgery. You’ll be allowed to consume clear liquids during most of the 24-hour period but should stop two hours before surgery.
Conduct an ultrasound the day of surgery to assess whether your stomach is empty.
If the ultrasound shows that your stomach isn’t empty or if the results aren’t clear, there are two options your anesthesiologist can discuss with you so you can make a shared decision:
- Proceed with the surgery, with the Anesthesia Care Team following what’s known as “full-stomach precautions.” These precautions alter the way your general anesthesia is administered.
- Postpone the surgery or procedure.

The use of full-stomach precautions reduces the risk of aspiration. But the precautions require the anesthesiologist to use a predetermined dose of the anesthetic drug that will make you unconscious and unaware during surgery. Using a predetermined dose instead of adjusting the amount based on your response to the anesthetic can lead to more side effects from the drug.

Importantly, full-stomach precautions are available as an option only for general anesthesia. It is not an option for sedation, which is often used for procedures such as upper GI endoscopy or colonoscopy. Because of this, your anesthesiologist may recommend that you receive general anesthesia instead of sedation.

What conditions raise my risk from taking GLP-1 drugs before surgery?

If you’re taking a GLP-1 agonist drug such as Ozempic, Wegovy, or Mounjaro, you may be at higher risk if any of the following situations apply to you:

You’re gradually increasing your dosage because you’re just starting on the drug. This escalation phase usually lasts four to eight weeks, and during this time you’re more likely to have slow stomach emptying. It’s best to wait until the escalation phase is over and any stomach problems have gone away.
You’re constipated, nauseous, throwing up, experiencing stomach pain, or having trouble breathing. You shouldn’t undergo surgery until the symptoms are gone.
Your daily or weekly dose of the drug is higher than typically prescribed. A higher dose is more likely to cause stomach-related side effects, so you should go on a liquid diet for 24 hours before the surgery.
You have other medical conditions that can slow emptying of the stomach, like Parkinson’s disease. Your anesthesiologist may need to make additional changes to your care plans for before, during, and after surgery.

What happens if I need emergency surgery?

When someone needs urgent or emergency surgery, anesthesiologists are advised to treat the patient as having a full stomach and use full-stomach precautions. But if you are awake and alert in an emergency, you should let the anesthesiologist or surgical team know you are taking a GLP-1 agonist medication.