Planning for Surgery When Taking Ozempic® or Similar Medications

Ozempic®, also known as semaglutide, is an increasingly popular injectable medication that is highly effective in helping patients lose weight. While many people have heard of Ozempic®, it is just one example of a glucagon-like peptide-1 (GLP-1) agonist. All of these GLP-1 agonists act similarly to help reduce body fat:

• Semaglutide (Ozempic®, Rybelsus®, Wegovy®)
• Dulaglutide (Trulicity®)
• Liraglutide (Victoza®, Saxenda®)
• Exenatide (Byetta®)
• Tirzepatide (Mounjaro®)

If you are considering surgery while using a GLP-1 agonist, it is important to note that these medications impact how your body processes food and thus could influence both pre-operative preparations and post-operative recovery. Discussing your use of GLP-1 agonists with Dr. Abigail Rodriguez is crucial to ensure the best possible surgical outcomes.

Originally used for patients with Type 2 diabetes, this medication enhances the body’s insulin response to high blood sugar levels. It’s also very effective at reducing food intake by slowing down digestion in the stomach and reducing appetite. As a result, GLP-1 agonists can help patients lose weight and keep it down.

A research study showed that semaglutide, when combined with healthy lifestyle changes like diet and exercise, predictably helped reduce weight by about 15%, compared to 2.5% in patients who didn’t take the medication. While patients who used only lifestyle changes lost 5.7 lbs, patients who used semaglutide and lifestyle changes lost an average of 33.7 lbs.

Some of the more common side effects of GLP-1 agonists involve gastrointestinal issues like:

• Nausea
• Vomiting
• Diarrhea
• Constipation

For most patients, these symptoms are not severe and do not last long, going away over time as your body gets used to the medication. Rarely, more severe side effects can happen, which is why it’s important to get your GLP-1 agonist prescription from a physician who conducts a comprehensive evaluation of your health to ensure it is safe for you.

Dr. Rodriguez refers her patients to the physician-led ACPS™ Weight Loss Program, offering a GLP-1 agonist (tirzepatide) with personalized guidance from a registered nutritionist and a certified personal trainer. This multidisciplinary approach is designed to help you achieve your weight loss goals and learn healthy habits to maintain a lower weight for the long term. ACPS™ Weight Loss Program patients always have thorough health evaluations — including labs and imaging — before tirzepatide is prescribed.

As part of the ACPS™ Weight Loss Program, patients also undergo a Styku™ scan before and after. The Styku™ is a 3D camera that scans the body and precisely calculates:

• Body fat percentage
• Muscle mass percentage
• Bone mass percentage
• Visceral fat

It also measures the circumference of many locations on the body, such as the:

• Chest
• Waist
• Hip
• Thigh
• Calf
• Neck
• Arm

The Styku™ scan gives patients an instant visual demonstration of their weight loss and shows all the other important metrics involved, beyond just the number on the scale!

If you are taking a GLP-1 agonist, it’s crucial to inform Dr. Rodriguez so that she can safely prepare you for surgery and give you pre-operative instructions. While you’re asleep for surgery, the anesthesiologist will place a tube in your mouth and down into your windpipe (trachea) to help you breathe.

In rare cases, the placement of the tube can sometimes cause you to gag and even throw up. Any food or liquid in your stomach that is regurgitated can get into your lungs and cause severe problems.

This issue is much more likely to happen if you are taking a GLP-1 agonist, since they slow down the movement of food and liquid out of the stomach and into the intestine. To prevent this from happening, Dr. Rodriguez requires that you:

• Stop the GLP-1 agonist four weeks before surgery. This will allow your stomach to empty at an average rate again.
• Do not eat or drink anything after midnight before surgery.

If you take a GLP-1 agonist for Type 2 diabetes, Dr. Rodriguez will work with your PCP/Endocrinologist to develop an alternative plan for blood glucose management during the time around your surgery.

Some patients who use GLP-1 agonists can develop nutritional deficiencies if they do not adhere to a healthy, balanced diet. These deficiencies can result in serious issues with healing after surgery.

Therefore, if you take a GLP-1 agonist, Dr. Rodriguez will require that you get blood tests several months before surgery, including a complete metabolic panel and pre-albumin level. It is important to check these labs months before surgery to correct any nutritional problems with dietary changes and/or nutritional supplements.

Dr. Rodriguez also recommends drinking a high-protein nutritional shake every day, starting one week before surgery and continuing for two weeks after. This will help equip your body with the tools it needs to heal after surgery. If you are recovering well, Dr. Rodriguez will typically allow you to resume your GLP-1 agonist four weeks after surgery.

If you are considering plastic surgery and want to achieve the best possible outcomes, it’s essential to discuss your weight loss journey and any use of GLP-1 agonists with a knowledgeable and skilled surgeon. Schedule a consultation with Dr. Rodriguez, a board-certified plastic surgeon in Houston, to explore your options and create a personalized plan tailored to your needs and goals.