Should I stop taking Ozempic (semaglutide) before cosmetic surgery?

Semaglutide (Ozempic, Wegovy) belongs to a drug class that slows how quickly the stomach empties. Several studies have found that patients taking semaglutide were significantly more likely to have residual food or fluid in their stomachs before a procedure, even after following standard fasting instructions. One cohort study found residual gastric contents in 24% of semaglutide users compared with only 5% of non-users undergoing endoscopy under sedation. [1] A smaller prospective study found that 20% of patients who took their weekly semaglutide dose within the previous seven days still had stomach contents detectable on ultrasound right before elective surgery. [2] A broad scoping review covering 24 studies confirmed that the large majority of research links GLP-1 receptor agonists like semaglutide to higher residual gastric volume. [4] Reviews focused specifically on plastic and facial plastic surgery agree that discontinuation before general anesthesia should be considered because of these gastrointestinal effects. [3][6]

Advice has changed. In 2023 the American Society of Anesthesiologists advised holding weekly GLP-1 drugs for a week before elective surgery. In October 2024, joint guidance from the ASA and four other surgical and gastroenterology societies moved to shared decision-making: many patients can continue their GLP-1 drug, while those at higher risk of delayed stomach emptying, such as people in the dose-escalation phase, on higher doses, or with nausea, vomiting, or bloating, may be managed with a liquid diet for at least 24 hours before surgery, a modified anesthesia plan, or holding the drug. When a hold is chosen, the guidance suggests the original schedule of one week for weekly injections. [7] The timing data support this caution: in an ultrasound study, patients whose last weekly dose was one to three days before surgery were more likely to have a full stomach than those dosed four to six days earlier. [2] If you take semaglutide for diabetes, stopping it also affects blood sugar, so any change must be coordinated with your prescriber.

If you are on Ozempic for weight loss or diabetes and are planning a cosmetic procedure under sedation or general anesthesia, bring this up at your very first consultation. Do not stop or restart the medication on your own without guidance. Your anesthesia team may also use a bedside stomach ultrasound to check whether your stomach is empty before proceeding. [2] Beyond the anesthesia question, rapid weight loss from semaglutide can also change your face and body in ways that affect surgical planning, so your surgeon will want to know about your medication and how long you have been on it. [3][6]

Most of the studies on this topic are observational and relatively small, and none were conducted specifically in cosmetic surgery patients. [4] The evidence is strong enough that major anesthesia societies have issued advisories, but the ideal washout period is still debated. Individual factors such as your dose, how long you have been taking it, whether you have diabetes, and your digestive symptoms all matter. [1][5] This page provides general education only. Please work with your surgeon, anesthesiologist, and the provider who prescribes your semaglutide to make a personalized plan.