What the labels say
Both labels carry a warning titled "Pulmonary Aspiration During General Anesthesia or Deep Sedation". Aspiration, meaning stomach contents entering the lungs, has been reported in people on GLP-1 drugs having elective surgery or procedures. The labels tell prescribers to instruct patients to inform their healthcare providers of any planned surgery or procedure.[1][2] The labels do not give a stop date.
What the 2024 guidance says
In 2023 the American Society of Anesthesiologists suggested holding weekly GLP-1 drugs for a week before elective procedures. In October 2024, five societies (anaesthesia, gastroenterology, bariatric surgery and others) replaced that with guidance that most patients may continue their medicine. For people at higher risk (in the dose build-up, on higher doses, with active nausea, vomiting, bloating or constipation, or with other stomach-emptying problems), it suggests a liquid diet for 24 hours before the procedure, and lets the team consider holding the drug or using a stomach ultrasound, as a shared decision.[3][4]
What the data show
A meta-analysis of endoscopy studies found food left in the stomach in 14% of GLP-1 users versus 2.3% of non-users, but no significant increase in actual aspiration.[5] A large cohort found aspiration pneumonia at 4.15 versus 4.26 per 1,000 endoscopies (no increase), though procedures were more often stopped early because of retained food.[6]
What to tell your team
- Which GLP-1 medicine you take, the dose, and the day of your last injection
- Whether you are still increasing the dose
- Any nausea, vomiting, bloating or constipation in the past week
Whether to hold a dose is the surgical or anaesthesia team's call together with your prescriber; do not stop or skip on your own because of this page.
The short version
Short on the way. A 35-second captioned version of this page is in production for the Fewer Bites channel. It will be embedded here when it is live.
Questions to bring to your prescriber
Print these or screenshot them. They are conversation starters, not a checklist of things to do.
- Who should decide whether I hold a dose before this procedure: you, the surgeon or the anaesthesia team?
- Do I count as higher risk under the 2024 guidance, and should I follow a liquid diet the day before?
- When can I take my next dose after the procedure?
Education, not advice. This page explains what trials, labels and guidelines report. It does not tell anyone to start, change or stop a medicine. Your prescriber knows your history; this page does not.
Sources
- Novo Nordisk / FDA. Wegovy (semaglutide) injection and tablets, prescribing information, revised 06/2026. label
- Eli Lilly / FDA. Zepbound (tirzepatide) prescribing information, revised 08/2026. label
- American Society of Anesthesiologists. New multi-society guidance on GLP-1 receptor agonists before surgery and procedures, October 2024. primary read · society guidance
- Kindel TL et al. Multisociety clinical practice guidance for the safe use of GLP-1 receptor agonists in the perioperative period. Surg Obes Relat Dis 2024. primary read via Fewer Bites gut dossier · society guidance
- Tarar ZI et al. GLP-1 receptor agonists and retained gastric contents at endoscopy: systematic review and meta-analysis. Diagnostics 2025;15:770. primary read via dossier · meta-analysis of observational studies
- Alkabbani W et al. GLP-1 receptor agonists before upper GI endoscopy and risk of pulmonary aspiration or discontinuation of procedure: cohort study. BMJ 2024. primary read via dossier · cohort