GLP-1 medicines before surgery: what the multisociety guidance says

Why this study matters

GLP-1 medicines such as semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda, Victoza) slow stomach emptying. Anaesthesia teams have been concerned that food could remain in the stomach after the usual fasting period, raising the risk of stomach contents entering the lungs during sedation or anaesthesia. Different hospitals and specialties have handled this in different ways. This document is an attempt by several professional societies to agree on a shared approach. Canadian readers who take a GLP-1 medicine and have a procedure or operation coming up will hear their care team refer to guidance of this kind.

Who was in the study

This is not a study of patients. It is a guidance document written for clinicians. It applies to people receiving GLP-1 medicines who are about to have a procedure or surgery. The summary we reviewed does not report a number of participants, because there were none.

What the researchers did

The authors, drawn from multiple professional societies, reviewed the available evidence and reached agreement on practical advice for clinicians. The published document is described by its own authors as clinical practice guidance based on consensus, not as an evidence-based guideline. That distinction matters. An evidence-based guideline grades recommendations by the strength of the studies behind them. Consensus guidance reflects expert agreement where the evidence is limited, which the authors say was the case at the time of writing.

The focus of the guidance is safe management around the time of a procedure, including how to assess whether a person's stomach may be emptying slowly.

What they found

The central message is coordination. The guidance says that decisions about GLP-1 medicines before a procedure should involve the team that prescribes the medicine, the team doing the procedure and the anaesthesia team, because the risks depend on the individual person's situation (R32-C128).

For assessing delayed stomach emptying, the guidance points to an individual assessment that considers:

• whether the person has symptoms
• whether the person is in the dose-escalation phase, when doses are being stepped up
• whether the person has other reasons for slow stomach emptying

The summary we reviewed does not report a specific number of days to withhold a medicine, and this page does not offer one.

Side effects and people who stopped

This is a guidance document and does not report side effects or stopping rates.

What this study does not tell you

• The authors explicitly call this consensus guidance, not an evidence-based guideline, and note that evidence was limited at the time of publication.
• It does not give a withholding interval or instructions for any individual on this page.
• It was written for clinicians, and Canadian hospitals may follow their own local protocols.
• Guidance of this kind is updated as new evidence appears, such as the endoscopy and surgical cohort studies covered on this site.
• The summary we reviewed does not state who funded the work.

What it means in Canada

For Canadian readers, the practical point is that the question of what to do with a GLP-1 medicine before a procedure is not answered by one person alone. It involves the prescriber, the procedure team and the anaesthesia team, and it depends on symptoms, dose and other conditions. For how these medicines are used in Canada, see semaglutide in Canada and tirzepatide in Canada. For coverage questions, see public drug coverage by province.

Related reading

Other studies in this library that bear on the same question.

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