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GLP-1 Medications (Ozempic, Wegovy) and Your Surgery Info Evidence

Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed

What this medication is

GLP-1 medications are a group of medicines you may know by brand names such as Ozempic or Wegovy. Their full name is glucagon-like peptide-1 receptor agonists, or GLP-1 agonists for short. They were first used to treat type 2 diabetes, a condition where blood sugar levels run too high. They are now also widely used to help with weight loss in people living with obesity [1].

These medicines copy a natural hormone your body releases after you eat. That hormone does two main things. It reduces your appetite, so you feel full sooner and eat less. It also slows how fast your stomach empties, which keeps that full feeling going for longer [2]. The result for many people is steady weight loss and better blood sugar control [3].

If you take one of these medicines and you are planning surgery, it matters to your care team. These medicines are increasingly common, and surgeons now see more and more patients who take them [4]. Research into how they affect surgery is still growing, and some findings do not yet agree with each other [5] [6]. What is known so far is mostly reassuring in plain terms: studies following joint replacement patients have not found a clear increase in short-term problems after surgery [7] [8], and some research links these medicines to a lower chance of wound or infection trouble [9] [10]. Guidelines currently say you do not need to stop your medication before an elective procedure, because stopping can upset your blood sugar and your weight progress [11].

The rest of this page explains what this means for you around the time of your operation.

How it affects your surgery and anaesthetic

The main thing these medicines change around surgery is your stomach. Because they slow how fast your stomach empties, food and fluid can stay there longer than you or your care team would expect. Most studies have found that people taking these medicines have more leftover stomach contents than expected [12]. That matters because during an anaesthetic, stomach contents can come back up and enter your lungs. This is called aspiration. It is a known risk with any anaesthetic, and these medicines can add to it, although the evidence linking them to actual aspiration events remains mixed [12].

Your anaesthetist plans around this. Current Australian guidance is to keep taking the medication and to have clear fluids only for the 24 hours before surgery, with the usual fasting time falling within those 24 hours. Some teams also check the stomach with an ultrasound beforehand. Research has looked at these steps and found they may help reduce leftover stomach contents in some patients [13]. Your team will decide what applies to you.

There is also some good news about recovery. Studies of people having hip or knee replacement while taking these medicines have not found a consistent increase in short-term revision rates [8]. Some research links them to a lower chance of postoperative infection, including infection around the new joint [3] [8]. For hand surgery such as carpal tunnel release, one study found a small reduction in wound healing problems and no increase in other early complications [10].

Your care team manages all of this carefully. Surgeons, anaesthetists and diabetes specialists work together to plan the safest approach for you [2]. Researchers are still working out the best way to care for people on these medicines around surgery [14]. For now, the practical message is simple: tell your team you take this medication, follow their fasting instructions exactly, and they will handle the rest.

What you should do

Keep taking your GLP-1 medicine as usual before your operation; do not stop it. For the 24 hours before your surgery, have clear fluids only and no solid food. Clear fluids are drinks you can see through, such as water, clear apple juice, or black tea or coffee without milk. The usual fasting time before an anaesthetic is part of those 24 hours, not added on afterwards: towards the end, your anaesthetist will tell you when to stop the clear fluids as well. This follows the current Australian anaesthetic (ANZCA) guidance.

Keep taking your medication as prescribed, and tell everyone involved in your care that you take it. That includes your surgeon, your anaesthetist and your GP. It also includes the doctor who prescribed the medication, whether that is your GP or a specialist.

Do not stop taking it on your own. Stopping can affect your blood sugar and your weight progress.

Before your procedure, your team will give you clear instructions. Follow the guidance about your medication and about fasting beforehand exactly as written. Fasting means not eating or drinking for a set time before surgery. These steps help keep your stomach empty and lower the risks from the anaesthetic.

If you are unsure about anything, ask. Your surgeon, anaesthetist and GP work together to plan the safest approach for you. No question is too small when it comes to your medication and your operation.

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

References
  1. GLP-1 Receptor Agonists in Orthopaedic Surgery: Implications for Perioperative Care and Outcomes. *Journal of Bone and Joint Surgery*. 2025. 10.2106/jbjs.24.01287
  2. Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia. *The Korean Journal of Internal Medicine*. 2026. 10.3904/kjim.2025.277
  3. Semaglutide and Other GLP-1 Agonists: A Boon for the Arthroplasty Industry?. *The Journal of Arthroplasty*. 2024. 10.1016/j.arth.2023.12.014
  4. The Impact of Glucagon-Like Peptide-1 Agonists on Hip and Knee Arthroplasty and Perioperative Considerations. *The Journal of Arthroplasty*. 2024. 10.1016/j.arth.2023.12.002
  5. Glucagon-Like Peptide-1 Receptor Agonists: Have We Found the Holy Grail for Total Joint Arthroplasty?. *The Journal of Arthroplasty*. 2025. 10.1016/j.arth.2025.10.027
  6. Impact of Glucagon-Like Peptide-1 Receptor Agonists on Postoperative Outcomes in Arthroplasty: A Systematic Review. *The Journal of Arthroplasty*. 2025. 10.1016/j.arth.2025.07.015
  7. GLP-1 receptor agonist therapy is not associated with adverse events following shoulder surgery: a systematic review and meta-analysis. *Journal of Shoulder and Elbow Surgery*. 2026. 10.1016/j.jse.2025.12.005
  8. Glucagon-like peptide-1 receptor agonists in total joint arthroplasty: a comprehensive systematic review of what orthopaedic surgeons should know. *Arthroplasty*. 2026. 10.1186/s42836-026-00375-w
  9. The Association Between Glucagon-Like Peptide-1 Receptor Agonists and Postoperative Complications After Arthroplasty: A Systematic Review and Meta-Analysis. *The Journal of Arthroplasty*. 2025. 10.1016/j.arth.2025.06.083
  10. Impact of Perioperative Glucagon-Like Peptide-1 Receptor Agonists on Postoperative Outcomes Following Carpal Tunnel Release. *Journal of Hand Surgery Global Online*. 2025. 10.1016/j.jhsg.2025.100746
  11. Periprocedural use of GLP-1 receptor agonists: ANZCA Clinical Practice Recommendations. *ANZCA*. 2025.
  12. Perioperative anesthesia management of GLP-1 receptor agonists: a systematic review of potential risks. *Perioperative Medicine*. 2026. 10.1186/s13741-026-00662-9
  13. Peri-Procedural Fasting and Gastric Ultrasound Strategies in Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Users: A Systematic Review With Qualitative Synthesis. *Cureus*. 2026. 10.7759/cureus.108216
  14. GLP-1 agonists: a new hope for patients, a new challenge for anaesthetists. *Anaesthesiology Intensive Therapy*. 2025. 10.5114/ait/203167
Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Glucagon-like peptide-1 receptor agonists induce delayed gastric emptying [1].
  • The pharmacological mechanisms of GLP-1 RA-induced delayed gastric emptying have clinical implications for perioperative aspiration risk during anesthesia [1].
  • Interdisciplinary collaboration between endocrinologists and anesthesiologists is emphasized for safe and individualized perioperative management of patients on GLP-1 RAs [1].
  • GLP-1 agonists may not produce sufficient weight loss to achieve body mass index cutoffs for total joint arthroplasty depending on individual patient factors, including starting bodyweight [2].
  • Further high-quality studies are called for to address the optimal perioperative care of patients on GLP-1RAs due to their increasing popularity in patients with obesity [3].
  • Conflicting findings in the literature highlight the need for further research, particularly well-designed multicenter studies and randomized controlled trials, to clarify the effects of GLP-1 RAs on surgical outcomes [4].
  • Arthroplasty surgeons will encounter an increasing number of patients on GLP-1 agonists [5].
  • It is important for arthroplasty surgeons to understand the implications of GLP-1 agonist use in the perioperative period [5].
  • GLP-1 agonist use should not be a contraindication for proceeding with total shoulder arthroplasty based on data showing no association with adverse events following shoulder surgery [6].
  • Elective preprocedural cessation of GLP-1RAs and GLP-1/GIPRAs is not recommended due to insufficient data supporting cessation and risks of hyperglycaemia and compromised weight control [7].
  • The variability in available studies, potential confounding factors, and severe heterogeneity of conclusions emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 RAs [8].
  • GLP-1 agonists have effects on bone health that are relevant to perioperative patients undergoing orthopedic surgery, with an emphasis on spine surgery [9].
  • GLP-1RA use suggests a potential benefit for optimizing high-risk patients who have obesity or diabetes undergoing total joint arthroplasty [10].

Effects on Surgery and Recovery

Perioperative Anesthesia and Gastric Emptying

  • Authors call for further high-quality studies to address the optimal perioperative care of patients on GLP-1RAs due to their increasing popularity in patients with obesity [3].
  • Available observational evidence suggests that extended GLP-1 RA withholding, 24-hour clear liquid diets, and pre-procedural gastric POCUS may be associated with reduced residual gastric content in selected patient populations [14].

Arthroplasty Outcomes

  • Arthroplasty surgeons will encounter an increasing number of patients on GLP-1 agonists, making it important to understand the implications of their use in the perioperative period [5].
  • Conflicting findings highlight the need for further research, particularly well-designed multicenter studies and randomized controlled trials, to clarify the effects of GLP-1 RAs on surgical outcomes in arthroplasty [4].
  • Findings suggest a potential benefit of GLP-1RA use for optimizing high-risk patients who have obesity or diabetes undergoing total joint arthroplasty [10].
  • While GLP-1 receptor agonists show potential to reduce postoperative complications in total joint arthroplasty, findings remain inconsistent, and further research is needed to clarify their impact on outcomes and establish perioperative management guidelines [11].
  • Preoperative glucagon-like peptide-1 receptor agonist use may be linked to reduced readmission risk following joint arthroplasty, without evidence of increased postoperative medical harm [12].
  • Semaglutide and other GLP-1 agonists may increase the number of eligible candidates for elective total joint arthroplasty by enabling weight loss and improving diabetic control [13].
  • Semaglutide and other GLP-1 agonists may potentially reduce postoperative complications such as sepsis and prosthetic joint infections [13].
  • Current observational data suggest that perioperative GLP-1 RA use in patients undergoing total hip or knee arthroplasty is not associated with a consistent increase in short-term revision rates [16].
  • Current observational data suggest that perioperative GLP-1 RA use in patients undergoing total hip or knee arthroplasty may be associated with a reduced risk of postoperative infection [16].

Other Orthopedic Procedures

  • Based on data from a systematic review and meta-analysis, GLP-1 agonist use should not be a contraindication for proceeding with total shoulder arthroplasty [6].
  • Perioperative GLP-1RA use was associated with a small yet statistically significant reduction in the odds of wound dehiscence following carpal tunnel release [15].
  • Perioperative GLP-1RA use did not increase the odds of any other 90-day postoperative complications following carpal tunnel release [15].

Bone Health

  • A narrative review explores the mechanisms of action of GLP-1 agonists, their effects on bone health, and the implications of their use in perioperative patients undergoing orthopedic surgery, with an emphasis on spine surgery [9].
  • Exenatide is the best option agent with regard to the risk of fracture [17].

Practical Considerations

Perioperative Anesthesia and Gastric Emptying

  • Delayed gastric emptying induced by GLP-1 RAs has implications for perioperative aspiration risk during anesthesia [1].

Medication Management

Arthroplasty Outcomes and Eligibility

  • Conflicting findings highlight the need for further research, particularly well-designed multicenter studies and randomized controlled trials, to clarify the effects of GLP-1 RAs on surgical outcomes [4].

Shoulder Surgery

Bone Health and Spine Surgery

Key Evidence

  • [L4] This review summarizes the pharmacological mechanisms and clinical implications of GLP-1 RA-induced delayed gastric emptying, evaluates current literature on perioperative aspiration risk, and emphasizes the importance of interdisciplinary collaboration between endocrinologists and anesthesiologists to ensure safe and individualized perioperative management. [1] (10.3904/kjim.2025.277)
  • [Paper] While efficacious, GLP-1 agonists may not produce sufficient weight loss to achieve body mass index cutoffs for total joint arthroplasty depending on individual patient factors, including starting bodyweight. [2] (10.2106/jbjs.rvw.23.00167)
  • [L4] Due to the increasing popularity of GLP-1RAs in patients with obesity, the authors call for further high-quality studies to address the optimal perioperative care of patients on GLP-1RAs. [3] (10.5114/ait/203167)
  • [L4] However, conflicting findings highlight the need for further research, particularly well-designed multicenter studies and randomized controlled trials, to clarify the effects of GLP-1 RAs on surgical outcomes. [4] (10.1016/j.arth.2025.07.015)
  • [L5] Arthroplasty surgeons will encounter an increasing number of patients on GLP-1 agonists, making it important to understand the implications of their use in the perioperative period. [5] (10.1016/j.arth.2023.12.002)
  • [L1] Based on this data, GLP-1 agonist use should not be a contraindication for proceeding with TSA. [6] (10.1016/j.jse.2025.12.005)
  • [L2] The variability in available studies, potential confounding factors, and the severe heterogeneity of conclusions all emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 RAs. [8] (10.1186/s13741-026-00662-9)
  • [L4] This narrative review explores the mechanisms of action of GLP-1 agonists, their effects on bone health, and the implications of their use in perioperative patients undergoing orthopedic surgery, with an emphasis on spine surgery. [9] (10.1177/15563316261438492)
  • [L1] These findings suggest a potential benefit of GLP-1RA use for optimizing high-risk patients who have obesity or diabetes undergoing total joint arthroplasty. [10] (10.1016/j.arth.2025.09.054)
  • [L5] The paper concludes that while GLP-1 receptor agonists show potential to reduce postoperative complications in total joint arthroplasty, findings remain inconsistent, and further research is needed to clarify their impact on outcomes and establish perioperative management guidelines. [11] (10.1016/j.arth.2025.10.027)
  • [L1] Preoperative glucagon-like peptide-1 receptor agonist use may be linked to reduced readmission risk following joint arthroplasty, without evidence of increased postoperative medical harm. [12] (10.1016/j.arth.2025.11.036)
  • [L5] Semaglutide and other GLP-1 agonists may increase the number of eligible candidates for elective total joint arthroplasty by enabling weight loss and improving diabetic control, while also potentially reducing postoperative complications such as sepsis and prosthetic joint infections. [13] (10.1016/j.arth.2023.12.014)
  • [L4] Available observational evidence suggests that extended GLP-1 RA withholding, 24-hour clear liquid diets, and pre-procedural gastric POCUS may be associated with reduced residual gastric content in selected patient populations. [14] (10.7759/cureus.108216)
  • [L3] Perioperative GLP-1RA use was associated with a small yet statistically significant reduction in the odds of wound dehiscence following CTR and did not increase the odds of any other 90-day postoperative complications. [15] (10.1016/j.jhsg.2025.100746)
  • [L4] Current observational data suggest that perioperative GLP-1 RA use in patients undergoing total hip or knee arthroplasty is not associated with a consistent increase in short-term revision rates and may be associated with a reduced risk of postoperative infection. [16] (10.1186/s42836-026-00375-w)
  • [L1] Exenatide is the best option agent with regard to the risk of fracture. [17] (10.1007/s00198-018-4649-8)

References

[1] Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia. The Korean Journal of Internal Medicine. 2026. DOI: 10.3904/kjim.2025.277

[2] Glucagon-like Peptide-1 Agonists. JBJS Reviews. 2024. DOI: 10.2106/jbjs.rvw.23.00167

[3] GLP-1 agonists: a new hope for patients, a new challenge for anaesthetists. Anaesthesiology Intensive Therapy. 2025. DOI: 10.5114/ait/203167

[4] Impact of Glucagon-Like Peptide-1 Receptor Agonists on Postoperative Outcomes in Arthroplasty: A Systematic Review. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.07.015

[5] The Impact of Glucagon-Like Peptide-1 Agonists on Hip and Knee Arthroplasty and Perioperative Considerations. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.12.002

[6] GLP-1 receptor agonist therapy is not associated with adverse events following shoulder surgery: a systematic review and meta-analysis. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2025.12.005

[7] Periprocedural use of GLP-1 receptor agonists: ANZCA Clinical Practice Recommendations. ANZCA. 2025.

[8] Perioperative anesthesia management of GLP-1 receptor agonists: a systematic review of potential risks. Perioperative Medicine. 2026. DOI: 10.1186/s13741-026-00662-9

[9] GLP-1 Agonists in Orthopedic Surgery: A Narrative Review of Bone Health and Surgical Implications. HSS Journal. 2026. DOI: 10.1177/15563316261438492

[10] The Impact of Glucagon-Like Peptide-1 Receptor Agonist Use on Clinical Outcomes After Total Hip and Knee Arthroplasty: A Systematic Review and Meta-Analysis of 346,899 Patients. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.09.054

[11] Glucagon-Like Peptide-1 Receptor Agonists: Have We Found the Holy Grail for Total Joint Arthroplasty?. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.10.027

[12] Glucagon-Like Peptide-1 Receptor Agonists, Readmission, and Postoperative Complications in Arthroplasty: A Systematic Review and Meta-Analysis. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.11.036

[13] Semaglutide and Other GLP-1 Agonists: A Boon for the Arthroplasty Industry?. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.12.014

[14] Peri-Procedural Fasting and Gastric Ultrasound Strategies in Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Users: A Systematic Review With Qualitative Synthesis. Cureus. 2026. DOI: 10.7759/cureus.108216

[15] Impact of Perioperative Glucagon-Like Peptide-1 Receptor Agonists on Postoperative Outcomes Following Carpal Tunnel Release. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100746

[16] Glucagon-like peptide-1 receptor agonists in total joint arthroplasty: a comprehensive systematic review of what orthopaedic surgeons should know. Arthroplasty. 2026. DOI: 10.1186/s42836-026-00375-w

[17] Glucagon-like peptide-1 receptor agonists and fracture risk: a network meta-analysis of randomized clinical trials. Osteoporosis International. 2018. DOI: 10.1007/s00198-018-4649-8

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