Surgery soon? Tell your anesthesia provider about weight loss medications now

Health-related goals are some of the most common New Year's resolutions. Everyone’s health journey is different, and for many this means taking medications or supplements that support weight loss. For others, this may mean crossing a surgery or diagnostic procedure off the to-do list. And for some, it can mean doing both.

If you’re planning an upcoming surgical procedure of any kind, it’s important to have an honest talk with your anesthesia provider about prescriptions and supplements you are taking. "At the start of the year there is a trend in people taking more supplements and medications as they focus on their health-related resolutions, and they may not realize the potential interactions with anesthesia drugs," said Dru Riddle, PhD, DNP, CRNA, FAAN, president of the American Association of Nurse Anesthesiology (AANA).

This is particularly important if your resolution is to lose weight and you plan to use medications such as Ozempic^® or Wegovy^® (semaglutide), Saxenda^® (liraglutide) or Zepbound™ (tirzepatide).

Glucagon-like peptide-1 (GLP-1) agonists, designed initially to manage type 2 diabetes, are also used for weight loss and require additional preparation for anesthesia providers to help minimize any complications during a procedure. For example, these medications delay the emptying of food from the stomach. Clinical guidelines call for a patient to fast prior to anesthesia. Food remaining in your stomach can cause serious complications such as vomiting and food aspiration into your lungs. Because of these risks, your provider may need to do additional screenings such as an ultrasound of your stomach contents before your surgery if you are taking these medications.

Follow expert recommendations

According to AANA, if you are the patient or a caregiver to the patient, it's important to talk to your surgical team about recommendations for withholding GLP-1 medications prior to surgery. You and your surgical team should discuss and consider:

• If daily dose: hold day of surgery or procedure
• If weekly dose: hold 1 week before surgery or procedure

Each year, millions of people in the United States undergo various surgical and diagnostic procedures requiring anesthesia care. Certified Registered Nurse Anesthetists (CRNAs) safely provide 50 million anesthetics per year, working in every setting in which anesthesia is delivered. CRNAs partner with you to create an anesthesia and pain management care plan that addresses all aspects of your care before, during and after the procedure.

"Because medications, vitamins and other supplements may interact with anesthesia drugs or increase risk of complications, such as bleeding during surgery, it's important to tell your CRNA and surgical team about everything you take," said Micah Walden, DNAP, CRNA, a member of the AANA Practice Committee. "Some medications may have to be adjusted or temporarily stopped before your surgical procedure, and anesthesia medication delivery may require modifications."

Herbal supplements can impact your anesthesia care as well. AANA recommends you inform your surgeon and anesthesia professional about all herbal products as well as over-the-counter drugs, dietary supplements, minerals and teas. Your health care team will recommend a timeline that is best for you and the supplements you are taking. Depending on the product, you may be instructed to stop taking herbal or over-the-counter products at least 1-2 weeks prior to the scheduled procedure or surgery to prevent side effects, while others may have a longer time period.

If you are not sure about any prescription or supplement you take, bring the containers with you to your preoperative anesthesia assessment and evaluation. During this time, you will also want to communicate your health history, prescription medications, allergies, cultural beliefs, and smoking or recreational drug use, including cannabis. It’s critical to be honest so the team has all the information needed to help care for you properly before, during and after your procedure.

Additional resources

Having health goals is admirable. If you decide to take supplements or medications to support these goals and have an upcoming surgery, make sure to communicate everything clearly and honestly with your anesthesia provider and health care team. For more information on CRNAs and anesthesia care, visit AANA.com.