GLP use has exploded. The number of patients who are on it for the 10 pounds they gained in menopause, or they were overweight, or they are microdosing for health and longevity benefits is staggering.
I am not going to address the bigger GLP picture here. I think there is a lot of goodness to these medications when they are done under supervision, are high quality, labwork is followed, and there is a distinct goal. These are bioactive substances. You need to follow your labs, weight, and body fat and muscle percentages. More is not better, and being too skinny has a host of issues.
GLPs have an effect on how much you eat, what you eat, and how quickly your GI system empties. These all have an effect on surgery.
This is real. Many people just don’t feel like eating. “I need to remind myself to eat.” This is fine when you are not asking your body to do a big thing. Surgery is like running a marathon. You need lots of energy coming in so your body has fuel to heal. We will get into what you eat next, but your body needs calories to heal. If you don’t give it energy, you are at bigger risk for poor healing, scarring, wound breakdown, or infection.
Do not go into a surgery being calorie depleted.
There is an effect on what you eat when you are on a GLP. Entire industries are changing. Commonly you hear that people drink less alcohol, and they also tend to eat less junk food. All of that is fine for surgery.
When on a GLP and when going into surgery WHAT you eat is important. In general we advise all our GLP patients to be on a high protein diet. It is better for weight loss and for building muscle. High protein is also good for surgical healing. Eating a high protein diet for one month ahead and one month after surgery has statistically significantly been shown to help with prettier scars and lower infection. We also love creatine, and we carry Biohackr Health German micronized creatine powder- most pure, bioavailable, and stable form of creatine.
NOTE: We have advice on diet, vitamins, and other ways to optimize surgical healing which we share with our patients at preop. Again, what you eat is important to healing.
One of the major effects of all the GLPs (semaglutide, tirzepatide, or retatrutide) is that they slow gastric emptying. You feel “full” longer. The issue with this is that it raises your risk for aspiration during a general anesthesia surgery. Know how we make people stop eating after midnight the night before surgery? Wonder why? It is so your stomach is empty when they put you under anesthesia. We don’t want your stomach contents to go backwards and end up in your lung- that can cause “aspiration” which can lead to pneumonia.
We know GLP patients have stuff in their tummies longer, even seeing remnants of something they ate a week ago (!). So at our center we stop all GLPs two weeks prior to surgery. (The official ASA recommendation was one week, and currently some say you can take up to a day before surgery, but we have had issues with that, so we do two weeks at our center to ensure safety.)
I don’t restart it right away. Surgery is a stress. I want you getting calories, nutrition, and no side effects while your body is healing. It is dealing with enough already to heal from a surgery. So I tend to have patients wait around 2 weeks, depending on how they are healing and feeling. When your body feels less shell shocked, depending on the size of your surgery (was it a 6 hour mommy makeover? or an eyelid surgery?), you restart.
This is my approach in my office. I am a huge fan of GLPs. I think it may be a key to many disease processes and longevity. For anyone who is trying to lose weight, they are amazing and have revolutionized weight loss. Being at a healthy normal weight for surgery improves surgical results and lowers risk.
But we are still figuring GLPs out. The aspiration risk is real. The nutrient and calorie risk is real. You can’t go into a surgery from a depleted state.
To read about GLPs and plastic surgery, ready my blogs GLP BLOGS
The information provided on this website is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider for any questions regarding your health or medical condition.
