Surgical Risks May Result from Ozempic, Wegovy Use Before Anesthesia, Experts Warn

With the diabetes medications Ozempic and Wegovy increasingly being used as weight loss drugs, health experts are raising concerns about surgical risks patients may face, with recent research suggesting that side effects may include suffocation during anesthesia treatments.

In a press release issued late last week, the American Society of Anesthesiologists (ASA) warned against using the medications before elective surgery, due to the risk of vomiting and aspiration during anesthesia.

The Wegovy and Ozempic warning is part of new guidance by the ASA, amid much wider use of the drugs.

Ozempic (semaglutide) was originally approved for the treatment of people with Type 2 diabetes. However, in recent months Ozempic, along with a similar drug, Wegovy, has been increasingly prescribed for weight loss. While Wegovy is approved for weight loss use, Ozempic is not, and is prescribed “off-label” as a diet medication by a growing number of doctors.

Both drugs are part of a class of diabetic medications known as glucagon-like peptide-1 (GLP-1) receptor agonists, which also includes Trulicity, Byetta and others.

Wegovy, Ozempic Anesthesia Surgical Risks

According to the new guidance by the ASA, the drugs work by delaying the emptying of the stomach, which leads to less hunger. However, that means that during surgery and anesthesia, the stomach may not be empty, which could lead to vomiting and suffocation.

“While there is currently a lack of scientific data on how GLP-1 receptor agonists affect patients having surgery and interact with anesthesia, we’ve received anecdotal reports that the delay in stomach emptying could be associated with an increased risk of regurgitation and aspiration of food into the airways and lungs during general anesthesia and deep sedation,” ASA President Michael W. Champeau said in the press release. “These complications can be serious, so we are providing guidance on when GLP-1 agonists should be stopped in advance of an elective procedure.”

The guidance, created by the ASA Task Force on Preoperative Fasting, includes a list of recommendations for those taking the drugs and preparing to undergo elective surgery.

The ASA task force recommends that if patients take a drug like Ozempic or Wegovy on a daily basis, they should not take it the day of the procedure. If they take the drug on a weekly basis, they should pause taking the medications a week before their surgery. In addition, they should consider consulting with an endocrinologist while off the drugs to help control their diabetes.

The guidance also calls for doctors to consider delaying the procedure if the patient is experiencing gastrointestinal symptoms, such as severe nausea, vomiting, abdominal bloating or abdominal pain the day of the procedure. If there are no symptoms, but the drugs were not paused before surgery, doctors should proceed with the assumption that the patient has a full stomach, or conduct an ultrasound to determine the stomach’s contents.

If the patient’s stomach is empty, they can proceed as normal, but if it is full or the ultrasound is inconclusive or not possible, they should consider either delaying the procedure or moving forward with precautions assuming that the stomach is full.

In addition, the guidance calls for precautions assuming a full stomach in cases of urgent or emergency surgical procedures.

Concerns About Ozempic Side Effects

The warning comes amid increasing reports that Ozempic side effects have been linked to hair loss when using the diabetes drug as a weight loss treatment.

Some doctors have claimed hair loss after Ozempic use is a natural result of rapid weight loss. This effect is known as telogen effluvium. However, Ozempic may also cause hormonal shifts which can also trigger early onset pattern hair loss in men and women, known as androgenic alopecia, which is progressive and continues to worsen over time. This can lead to permanent hair loss, some health experts warn.

In May, the founder of The American Hair Loss Association (AHLA) and The International Alliance of Hair Restoration Surgeons, warned against misuse of Ozempic for weight loss in an editorial in Dermatology Times, indicating that the hair loss experts do not recommend the off-label use of the diabetes drug.

In addition, last month regulators in the European Union warned that Ozempic and Wegovy may be linked to an increased risk of thyroid cancer. They called for drug manufacturers to turn in additional data and suggested they may take future actions to address the potential risks.

August 2023 Ozempic Lawsuit Update

The first of what could be thousands of Ozempic lawsuits to come was filed by a Louisiana woman on August 2, 2023, claiming she experienced severe gastroparesis and stomach problems after using Ozempic for more than a year before switching to the similar diabetes drug Mounjaro.

The lawsuit claims both Novo Nordisk, the manufacturer of Ozempic, and Eli Lilly, the manufacturer of Mounjaro, both knew, or should have known, that the drugs increase the risk of gastroparesis and gastroenteritis that can lead to severe side effects such as nausea, vomiting undigested food, abdominal pain, abdominal bloating, severe dehydration, feeling full after only a few bites, undigested food hardening in the stomach, acid reflux, fluctuating blood sugar levels, lack of appetite, weight loss, malnutrition and decreased quality of life.

The lawsuit notes that despite a number of case studies and clinical reports warning that the drugs could cause, or exacerbate, gastroparesis in particular, neither manufacturer has updated the label warnings.

Similar problems stated in the lawsuit were outlined in a CNN report published on July 25, detailing several incidents of stomach paralysis, also known as gastroparesis, as well as previous research that has linked these types of diabetes drugs to similar risks in the past.

As a result of the growing number of Ozempic, Wegovy and Mounjaro gastroparesis side effects reported, it is expected that thousands of individuals who have suffered similar injuries will begin filing claims raising similar allegations that the manufacturers failed to adequately research and warn the medical community about potential side effects.