GLP-1 Medications Before Plastic Surgery: What to Tell Your Medellín Anesthesia Team

Why anesthesia teams ask about these drugs

GLP-1 receptor agonists help with blood sugar and weight partly by slowing how quickly food leaves the stomach. That is useful in daily life and a concern on the operating table. Under general anesthesia or deep sedation, the reflexes that normally protect your airway are reduced. If the stomach still holds food or fluid, there is a risk of aspiration, where stomach contents enter the lungs.

The fasting instructions you get before surgery assume a stomach that empties at a typical rate. A GLP-1 drug can upset that assumption. The question for your team is how much it is likely to do so in your case.

This article is about the days around surgery. If you lost a lot of weight on a GLP-1 and are wondering whether you are ready for body contouring at all, that is a separate question. It is covered in plastic surgery after major GLP-1 weight loss.

What changed in 2024

Earlier advice often told patients simply to stop their weekly injection about a week before surgery. In October 2024, the American Society of Anesthesiologists announced multi-society guidance (2024). It was developed with gastroenterology, bariatric surgery, perioperative obesity care and endoscopic surgery societies, and it moved away from a blanket stop date. Its main points, paraphrased:

• Most patients can continue their GLP-1 medication before elective surgery.
• Stopping has trade-offs too, such as higher blood sugar in people with diabetes, so the decision should weigh both sides.
• Higher-risk patients should follow a liquid-only diet for 24 hours before the procedure.
• Patients still in the dose-escalation phase, which the guidance says typically lasts four to eight weeks, are more likely to have delayed stomach emptying. Elective surgery should be deferred until that phase has passed and side effects have settled.
• Patients with active digestive symptoms, such as nausea, vomiting, abdominal pain or constipation, should wait until those resolve.
• On the day, the team can use point-of-care ultrasound to look at stomach contents, adjust the anesthesia plan to reduce aspiration risk, or, in rare cases, delay surgery.
• The decision is shared between the anesthesiologist, the surgeon and the doctor who prescribes your medication.

The release also cautions against withholding these drugs only because a patient is overweight or obese, calling that potentially biased.

The guidance is from US societies. Your Medellín team may apply it, or its own protocol, and they make the final call. What it gives you is the vocabulary to have an informed conversation, and a reason not to rely on an old stop date from social media.

The five facts your team needs

Also say why you take it. A patient using semaglutide for type 2 diabetes needs a blood-sugar plan if any dose is held. A patient using it only for weight has a different calculation. If you take other diabetes medications, list them too.

Timing your trip around the dose schedule

Medical travel creates GLP-1 problems that local patients don't face:

• Don't schedule a dose increase just before you fly. If your prescriber was planning to raise the dose, ask whether it can wait until after recovery, or whether surgery should move. Per the 2024 guidance, the weeks after an increase are when emptying is most affected.
• Work out which dose falls nearest to surgery day, in Colombian time, and agree with both your prescriber and the Medellín team what happens to it. Write the agreed plan down.
• Ask about the 24-hour liquid diet in advance. If your team wants it, plan where you will stay and what you will drink the day before surgery. Hotel room service is not built for clear-liquid days.
• Travel days can bring on symptoms. Flying, a changed diet and nerves can all upset your stomach. If nausea or vomiting starts after you land, tell the clinic straight away rather than waiting for the pre-op visit.
• Bring enough medication for the whole trip, in its original packaging with your prescription. Plan how to keep injectable pens at the right temperature. Don't count on getting the same product in Colombia.

Questions to ask about the clinic's GLP-1 protocol

You are entitled to know how the team will handle your medication before you pay a non-refundable deposit. Useful questions:

• Do you follow the 2024 multi-society guidance, or your own written protocol? Can I see it?
• Who reviews my GLP-1 details before I travel: the surgeon, the anesthesiologist or a nurse coordinator?
• Do you use gastric ultrasound on surgery day when there is doubt?
• If I am judged higher risk on the day, what options do you have besides cancelling, such as a different anesthesia approach?
• If surgery has to move because of my medication or symptoms, how is the new date and any extra cost handled?
• Will you talk to my prescriber directly, or should I relay the plan myself?

A clinic that answers these clearly, and in writing, is showing you how it handles risk in general, not just for this one drug.

When to restart

If a dose is held, ask before surgery when to restart and who decides. After body contouring you may be eating less, taking pain medication that can cause constipation, and recovering in a recovery house without your usual routine. Restarting a drug that causes nausea in that setting needs a plan. Agree who to message, the surgeon, the anesthesia team or your home prescriber, if you are unsure.

Saying it in Spanish

Most Medellín clinics that serve international patients work in English, but nurses on a night shift may not. Two sentences worth saving in your phone:

• "Uso semaglutida (o tirzepatida) una vez por semana. Mi última dosis fue el [fecha]." I use semaglutide (or tirzepatide) once a week. My last dose was on [date].
• "Tengo náuseas desde [día]." I have had nausea since [day].

Where this fits in your pre-op conversations

GLP-1 use is one item in the broader anesthesia review. It should appear on the first line of what you send, not as an afterthought on surgery morning. Our article on the anesthesia consultation before plastic surgery abroad lists the other questions to cover in that conversation.

Frequently asked questions

Do I have to stop Ozempic or Mounjaro a week before surgery?

Not necessarily. The 2024 multi-society guidance says most patients can continue GLP-1 drugs before elective surgery. The decision depends on your dose, the escalation phase and your symptoms. Your anesthesia team and prescriber decide together.

What is the 24-hour liquid diet?

The guidance recommends a liquid-only diet for 24 hours before the procedure for patients at higher risk of digestive side effects, such as those on higher doses. Your team will say whether it applies to you and which liquids are allowed.

I just increased my dose. Is that a problem?

It can be. The guidance says delayed stomach emptying is more likely during dose escalation, which typically lasts four to eight weeks, and suggests deferring elective surgery until that has passed. Tell your team the date of your last increase.

What happens if I feel nauseous the week of surgery?

Tell the clinic straight away. Under the guidance, active nausea, vomiting or abdominal pain is a reason to wait until symptoms resolve. That may mean a delay, so build flexibility into your travel plans.

Will they check my stomach on surgery day?

Some teams may. The guidance says point-of-care ultrasound can be used just before the procedure to assess stomach contents in higher-risk patients. Availability and practice vary, so ask your clinic what it does.