Implementation of GLP-1 Receptor Agonists for Perioperative Weight Loss

Authors

• Anne W. Shand, University of LynchburgFollow

Abstract

Obesity affects more than 40% of adults in the United States and contributes to significant perioperative risk, prompting widespread use of weight-loss interventions to optimize surgical readiness. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as highly efficacious pharmacologic options for weight reduction, with commonly used agents including semaglutide, tirzepatide, and liraglutide. This structured literature review examined whether GLP-1 RA therapy can support clinically meaningful preoperative weight loss and improve surgical optimization compared with traditional lifestyle-based approaches.

Evidence from randomized trials and emerging perioperative studies demonstrates that GLP-1 RAs typically achieve an 8–15% reduction in total body weight, often doubling or tripling the weight loss achieved with behavioral modification alone. In surgical cohorts, GLP-1 use has been associated with shorter time to surgical eligibility, improved glycemic and blood-pressure control, and potentially reduced postoperative complications. Adverse gastrointestinal effects such as nausea remain common but are usually transient and infrequently lead to treatment discontinuation. Because GLP-1 therapy can delay gastric emptying, current anesthesia guidance emphasizes individualized perioperative planning when determining whether to temporarily pause treatment.

Although long-term surgical outcome data remain limited, severe perioperative complications directly attributable to GLP-1 use have not been clearly identified. Limitations of the available evidence include small sample sizes, heterogeneous surgical populations, and limited data on long-term postoperative outcomes. Overall, current evidence supports thoughtful clinical integration of GLP-1 therapy into preoperative care. GLP-1 receptor agonists represent a promising adjunct for preoperative weight optimization and may enhance contemporary perioperative pathways. Further research is needed to standardize protocols, evaluate long-term surgical outcomes, and improve equitable access to therapy.

Recommended Citation

Shand AW. Implementation of GLP-1 Receptor Agonists for Perioperative Weight Loss. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).