Evidence-graded answer
Do I need to stop GLP-1 before surgery?
Yes. ASA 2023 guidance recommends holding daily GLP-1 (liraglutide) for 1 day, weekly GLP-1 (semaglutide, tirzepatide) for 1 week before elective procedures requiring anesthesia. The reason: delayed gastric emptying increases aspiration risk on induction.
ASA (American Society of Anesthesiologists) 2023 consensus: 1-week hold for once-weekly GLP-1, 1-day hold for daily liraglutide, regardless of fasting time.
Case reports of aspiration pneumonia during anesthesia drove the guidance. Risk is lower for purely elective procedures with strict NPO; higher for emergency procedures.
Communicate with both your prescriber and anesthesiologist. Restart can usually happen 3-7 days post-op once GI function recovers; coordinate with the surgical team if you have T2D.
Source: ASA GLP-1 Pre-Procedural Guidance 2023, ASA