Many people on Ozempic or Wegovy end up facing surgery at some point, whether planned or unplanned. Patients and anesthesiologists have both wondered how the drugs behave once anesthesia enters the picture. The early signals were unsettling.
A large new analysis of more than two million US surgical patients suggests the picture is milder than feared. Those taking GLP-1 drugs had slightly fewer major heart complications and infections after elective surgery, not more.
The findings were presented on October 18 at the ANESTHESIOLOGY 2026 annual meeting by a team from McGovern Medical School at UTHealth Houston.
The researchers analyzed records from more than two million US adults who had elective surgeries lasting over an hour, from January 2016 through December 2024. About 7 percent of the patients were taking a GLP-1 drug.
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In the GLP-1 group, the odds of a major cardiovascular event were 11 percent lower than in matched non-users. The event list included heart attack, heart injury, stroke and death.
The odds of a postoperative infection were 8 percent lower. The infection list included surgical site infections, urinary tract infections, pneumonia and sepsis.
GLP-1 drugs are a class of injections used for type 2 diabetes and weight loss. The best known are semaglutide, the active ingredient in Novo Nordisk's Ozempic and Wegovy, and tirzepatide, the active ingredient in Eli Lilly's Mounjaro and Zepbound.
About 12 percent of US adults say they currently take a GLP-1 drug, according to a KFF poll conducted in late 2025.
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Why anesthesiologists started pausing the drugs in 2023
The worry was aspiration. GLP-1 drugs slow how fast the stomach empties, which can leave food behind during anesthesia and raise the risk of inhaling it into the lungs.
In mid-2023, the American Society of Anesthesiologists advised pausing the drugs before elective surgery. A multi-society update in October 2024 reversed much of that.
Most patients can now continue their GLP-1 before surgery. Those at higher risk of a full stomach, including people on weekly injections or higher doses, are told to switch to a liquid diet for 24 hours beforehand.
What the numbers do not prove
The study is observational. The researchers compared records, they did not randomly assign anyone to a drug, which means the groups may differ in ways the matching cannot fully capture.
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Healthier people may also be more likely to be on a GLP-1 drug and to recover better from surgery for reasons unrelated to the medication itself.
Lead author Josephine Tolan is an anesthesiologist at the Center for Outcomes Research at UTHealth Houston. She said the findings should be read with that caveat in mind.
"GLP-1 medications have become part of everyday care for many people with diabetes or obesity, but physicians still need more evidence about how these drugs affect patients around the time of surgery," Tolan said.
The analysis was presented at a meeting and has not yet been published in a peer-reviewed journal. Current practice remains unchanged. Most patients can keep their GLP-1 running up to the day of elective surgery, with liquid-diet precautions for those at higher aspiration risk.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.