GLP-1 Receptor Agonists Before Aesthetic Surgery
Guidance on GLP-1 receptor agonists before anaesthesia has moved from routine holding towards individual risk assessment. This page summarises what two key sources say and how SurgiCheck routes GLP-1 use to the right clinician. It does not set a holding interval or a fasting rule.
What the sources say
- MHRA Drug Safety Update, 28 January 2025. Anaesthetists should include aspiration risk in the assessment of every patient taking a GLP-1 or dual GIP/GLP-1 receptor agonist, whatever the indication, individualised and identified early, ideally at pre-assessment. Fasting should not be assumed to guarantee an empty stomach, and patients may not volunteer use (some obtain these medicines privately), so they should be asked directly. The update gives no specific pause time. Source.
- Multi-society clinical practice guidance (AGA, ASMBS, ISPCOP, SAGES; affirmed by ASA), Surg Endosc 2025;39:180–183. GLP-1 receptor agonists are not routinely held; the decision follows shared decision-making between procedural, anaesthesia and prescribing teams. Risk factors to assess include the escalation phase, higher doses, weekly dosing, gastrointestinal symptoms and conditions that delay gastric emptying. Options include a liquid diet for at least 24 hours and point-of-care gastric ultrasound. The document is consensus-based because supporting data are limited. Source.
How SurgiCheck routes GLP-1 use
| Pathway | Situation | Who acts |
|---|---|---|
| VERIFY | GLP-1 use reported: symptom, titration and gastric-emptying assessment must be recorded before a tier can be set | Clinician, anaesthetist |
| INFO | Stable dose and no relevant GI symptoms: recorded; anaesthesia confirms the plan | Anaesthetist |
| REVIEW | Dose escalation without active GI symptoms: anaesthesia review recommended, with the options above to consider | Anaesthetist (dual-authorised override where marked) |
| DEFER | Active high-risk aspiration findings: deferral and anaesthesia reassessment recommended | Anaesthetist (dual-authorised override) |
GLP-1 use alone is not an automatic contraindication. The clinician's assessment (Standard, Review or Defer) sets the pathway, and the anaesthetist owns the plan.
What SurgiCheck does not do
- It does not tell a patient to stop or continue a medicine, and it does not set a fasting or holding schedule.
- It does not replace the anaesthetist's assessment. It makes sure the assessment is requested, assigned and recorded.
See how this fits the wider rule set and the pathway model.
Sources
MHRA. GLP-1 and dual GIP/GLP-1 receptor agonists: potential risk of pulmonary aspiration during general anaesthesia or deep sedation. Drug Safety Update, 28 January 2025.
Kindel TL, Wang AY, Wadhwa A, et al. Multi-society clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surg Endosc 2025;39:180–183.