Last reviewed: September 29, 2026

Often not anymore. Advice on this has changed in the last few years, and it still differs between hospitals and countries.

These drugs, such as semaglutide and tirzepatide, slow the emptying of the stomach. The worry is that food can still be in the stomach on the day of surgery, even after normal fasting, and be breathed into the lungs under anesthesia.

In 2023, the American Society of Anesthesiologists advised holding a weekly dose for one week before surgery. In 2024, it backed newer guidance from several societies. That guidance says most people can keep taking the drug, sometimes with a liquid diet the day before, with extra care for people at higher risk, such as those whose dose was recently raised or who have stomach symptoms. British and Australian guidance also favor continuing it.

The evidence behind all of this is weak. People on these drugs more often have food left in the stomach despite fasting, but pooled studies have not found more food breathed into the lungs. Whether holding a dose clears the stomach is uncertain.

In studies of hip and knee replacement, people taking these drugs had no more aspiration or pneumonia and were less often readmitted. Findings on other complications are mixed. These come from records, not trials.

In general:

  • Tell your surgeon and anesthesiologist that you take one of these drugs, and when you took the last dose.
  • Ask well before surgery whether to keep taking it, and whether to change what you eat the day before.
  • A recently raised dose, nausea, vomiting or bloating is worth mentioning before surgery.
  • If you take it for diabetes, ask how your blood sugar will be handled around surgery.

Drafted with AI assistance from published sources, reviewed and edited by Babak Sheikh, MD.

Sources:

This is general information about what published research shows. It is not medical advice and it is not about your situation. Reading it does not create a doctor-patient relationship with me. I am a retired orthopedic surgeon and I do not see patients. Talk with your own doctor before changing anything about your care. If something feels suddenly or seriously wrong, get medical care promptly rather than waiting.

This page is provided as is. I make no guarantee that it is accurate, complete or current, and medical evidence changes. Use of it is at your own risk.

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