Do you have to stop Ozempic, Wegovy, Mounjaro, or a similar GLP-1 medicine before surgery? Not always, and it depends on the medicine and your procedure. Here is the straight answer: these medicines slow how fast your stomach empties, which can leave food in it longer and raise the risk of stomach contents reaching your lungs under anesthesia, which is called aspiration. Early guidance leaned toward pausing them before elective surgery. More recent, risk-based guidance often lowers that risk without pausing the medicine at all, by extending your fasting window, adjusting the anesthesia plan, and sometimes checking your stomach with a quick bedside ultrasound. The most useful thing you can do is tell your anesthesia team the name of the medicine and when your last dose was, so they can apply the current guidance to you.

What these medicines are

GLP-1 receptor agonists are a family of drugs used to treat type 2 diabetes and to help with weight loss. Common brand names include Ozempic, Wegovy, Mounjaro, Zepbound, Rybelsus, and Trulicity. They work in part by slowing down how quickly the stomach empties, which is one reason they help people feel full for longer. Millions of people now take them, which is why this question has become one of the most common ones anesthesia teams hear.

Why they matter for anesthesia

The same effect that helps you feel full, slower stomach emptying, is the reason your anesthesia team wants to know about these medicines. During general anesthesia and deep sedation, the reflexes that normally protect your airway are relaxed. If the stomach still holds food or liquid, there is a small risk that stomach contents can come back up and get into the lungs. Anesthesiologists call this aspiration, and it is the reason for the whole routine of not eating before surgery. Because GLP-1 medicines can leave food in the stomach longer than usual, they can change how your team thinks about fasting and airway safety.

It helps to keep this in perspective. Aspiration is uncommon, and anesthesia teams have many tools to lower the risk. The point of this page is not to frighten you, it is to explain why this one question comes up so often now, and why your honest answer matters.

The guidance has changed, and may change again

This is a genuinely moving area of medicine. Guidance from professional societies has shifted more than once since 2023 as new evidence has come in, and it may shift again. The timeline below lays out what changed and when. In short, the earliest guidance leaned toward pausing these medicines before elective surgery, and more recent, risk-based guidance describes ways to lower risk that do not always require pausing the medicine, such as adjusting what you eat in the day before and, in some settings, using ultrasound to look at the stomach before anesthesia. Your team will apply the most current guidance to your specific case.

How your team may lower the risk

Recent patient guidance from the American Society of Anesthesiologists describes several steps an anesthesia team can take to lower risk without necessarily pausing the medicine. These can include asking you to avoid solid food for a longer window before surgery and to stick to clear liquids, choosing the type of anesthesia with your stomach in mind, and, in some places, using a quick bedside ultrasound to check whether the stomach is empty before starting. Not every hospital does all of these, and what is right for you depends on your health, your medicine, and your procedure. This is exactly the kind of plan your team tailors to each person.

If you ever need urgent or emergency surgery, teams are generally advised to treat the stomach as if it is full and to use extra airway precautions, so you do not need to worry that an unplanned operation cannot go ahead safely.

What to do

Tell your anesthesia team the name of your GLP-1 medicine, how your prescriber set up the schedule, and the date and time of your last dose. Ask them what they want you to do about eating and drinking in the days before your procedure. With your real details, they will apply the current guidance to your situation.