Life-threatening complication called pulmonary aspiration. This risk is particularly heightened for patients who take weight-loss drugs such as Wegovy and Ozempic, according to anesthesiologists in the U.S. and Canada.

These blockbuster drugs, which have seen nearly 6 million prescriptions written between January and May in the U.S. alone, work by mimicking gut hormones that regulate appetite and slow down digestion. While they have proven effective for weight loss, they also pose a significant danger for patients who require surgery or other procedures that require empty stomachs for anesthesia.

Anesthesiologists have reported an increasing number of cases where patients who followed the standard instructions to stop eating for six to eight hours before their procedures still had full stomachs. This can lead to food and liquid being inhaled into the lungs while sedated, causing pulmonary aspiration. The consequences of this can be severe, including lung damage, infections, and even death.

Dr. Ion Hobai, an anesthesiologist at Massachusetts General Hospital in Boston, emphasizes the seriousness of this issue and believes that all patients taking these weight-loss drugs should be aware of the risks. He was among the first to raise concerns about this complication. In response to the growing number of cases, the American Society of Anesthesiologists issued guidance in June advising patients to refrain from taking weight-loss medications on the day of surgery and to hold off on weekly injections for a week before sedation procedures.

However, some experts believe that this guidance may not go far enough. Dr. Michael Champeau, the president of the American Society of Anesthesiologists, acknowledges that there is not enough evidence to determine the exact duration for which these drugs should be stopped before procedures. Nevertheless, Dr. Philip Jones, a Mayo Clinic anesthesiologist, and deputy editor-in-chief of the journal, suggests that the drug should be halted for about three weeks before sedation, as that is the approximate time it takes for semaglutide, the active ingredient in Wegovy, to be eliminated from the body.

While this extended timeframe may be ideal for ensuring patient safety, it poses challenges for many patients who may not have the opportunity to see their healthcare providers far enough in advance to stop the drug three weeks prior to procedures. Aspiration occurs in approximately one out of every 2,000 to 3,000 operations that require sedation, and it is essential to find a balance between mitigating risks and practicality for patients.

In light of these concerns, Dr. Hobai and a group of colleagues have called for greater awareness and consideration of the risks associated with these weight-loss drugs. Further research is needed to establish evidence-based guidelines for the duration of cessation of medication before sedation procedures. In the meantime, it is crucial for healthcare providers and patients alike to have open conversations about the potential complications and make informed decisions regarding the use of these drugs in the context of surgical procedures.