Ozempic, Wegovy or Mounjaro Before Cosmetic Surgery in Medellín

A growing share of people planning cosmetic surgery are taking, or recently stopped, a GLP-1 medication: semaglutide (sold as Ozempic or Wegovy), tirzepatide (Mounjaro or Zepbound) and similar drugs. Some started them for diabetes, others for weight loss, and many are now booking body contouring precisely because the weight came off. If that's you, the medication needs to be part of your Medellín plan from the very first message to the clinic, not something you mention on the morning of surgery.

Why anesthesiologists care about these drugs

GLP-1 drugs slow the rate at which the stomach empties. That's part of how they reduce appetite. Under general anesthesia or deep sedation, food still sitting in the stomach raises the risk of aspiration, where stomach contents get into the lungs. Normal fasting rules were designed for typical stomach emptying, so a patient on a GLP-1 may not have the empty stomach the team assumes.

In October 2024, the American Society of Anesthesiologists announced new multi-society guidance (ASA, 2024) on GLP-1 drugs before elective procedures, developed with four other surgical, gastroenterology and obesity-medicine societies. The release noted that roughly one in eight US adults use these medications, which is why the question now comes up constantly.

What the 2024 guidance says, in plain language

The headline change was a move away from a blanket "stop it first" approach toward individual risk assessment. According to the ASA's summary:

• Most patients can continue the drug before elective surgery, particularly those at low risk of delayed stomach emptying.
• The decision is shared between the anesthesiologist, the surgeon and the doctor who prescribes the medication.
• Higher-risk patients may need extra steps, such as a liquid-only diet for 24 hours before the procedure, an adjusted anesthesia plan, or a quick ultrasound of the stomach before anesthesia to check its contents.
• Delaying surgery is reserved for specific situations where the risk is expected to go down with time.

The guidance also flagged reasons not to stop these drugs routinely: interrupting them can affect blood-sugar control for people with diabetes, and holding them can be costly or hard to restart. It also cautioned against holding the drugs only for patients with obesity, calling that a potential form of bias.

Who the guidance treats as higher risk

Three groups stand out in the ASA summary, and each has a direct consequence for trip planning:

The guidance also mentions that other conditions that slow stomach emptying, such as Parkinson's disease, may further change the plan.

Colombian teams may follow their own protocols

The 2024 guidance comes from US-based societies. Your anesthesiologist in Medellín may use it, may follow Colombian or institutional protocols, or may be more conservative. That's their call to make, and it's why you should ask early rather than assume. A team that asks to hold your medication for longer than you expected isn't necessarily wrong; ask them to explain their reasoning.

What you should not do is stop or change the drug on your own because something you read online said to. Changes belong with your prescribing doctor, who knows why you're taking it.

A message to send the clinic before you book

Put this in writing to the coordinator and ask for the anesthesiologist's answer, not just the coordinator's:

1. The exact drug, dose, and whether it's a weekly injection or a daily pill.
2. When you started, and the date of your last dose increase.
3. Whether you're taking it for diabetes, weight management or both.
4. Any current nausea, reflux, bloating, constipation or vomiting.
5. Your total weight loss so far, and whether it's still ongoing.
6. The question: "Do you want me to continue, hold or adjust this before surgery, and what fasting or liquid-diet instructions will I follow?"

Then share the answer with your prescriber at home and confirm they're comfortable with the plan. Our list of anesthesia questions for cosmetic surgery in Colombia covers the rest of that conversation.

Weight stability matters as much as the drug itself

Separate from anesthesia, there's a surgical question: is your weight done changing? Many surgeons prefer body-contouring patients to be at a stable weight before removing skin or fat, because further loss after surgery can change the result. If you're still losing steadily on a GLP-1, ask your surgeon whether they'd rather you wait until your weight plateaus.

This is especially relevant for skin-removal procedures after large weight loss. Our guide to body contouring after major weight loss explains how surgeons sequence those operations.

Nutrition and healing

Appetite suppression is the point of these drugs, but healing tissue needs adequate protein and nutrition. Some patients on GLP-1s eat very little without noticing. Ask your surgeon whether they want pre-op bloodwork that checks nutritional markers, and ask what they recommend for protein intake in the weeks around surgery. In Medellín, recovery houses can often accommodate high-protein meals if you ask ahead; if you're in a hotel, plan how you'll eat enough when you don't feel hungry.

Restarting after surgery

Ask the surgical team and your prescriber when you can resume the drug if it was paused, and whether nausea from restarting could be confused with post-operative symptoms. Agree on this before the trip so you aren't improvising from a recovery-house bed. If you'll be on opioid pain medication after surgery, mention that too, since both can slow the gut.

Sedation counts too

It's tempting to assume this only matters for big operations under general anesthesia. The ASA's summary refers to general anesthesia and deep sedation, and many cosmetic procedures in Medellín, including some facial and minor body procedures, use sedation. If you're booked for anything beyond local anesthesia, raise your GLP-1 use the same way.

Shipping and carrying your medication

If you continue the drug during the trip, plan for it practically: keep injectable pens in your carry-on with the pharmacy label, ask your prescriber for a short letter listing the medication, and check how it needs to be stored. Ask the recovery house or hotel whether you'll have access to a fridge in your room. Don't assume you'll be able to buy the same product in a Medellín pharmacy at short notice.

What about the morning of surgery?

Even with a plan agreed in advance, the final call happens on the day. Be ready for the anesthesiologist to ask again about your last dose, what you ate and drank and when, and whether you've had any nausea, bloating or vomiting since arriving in Medellín. Answer precisely. If you've broken the fasting or liquid-diet instructions, even slightly, say so; it's far safer to move a start time than to proceed on a wrong assumption.

Some teams may use a bedside ultrasound to check the stomach before anesthesia, which the 2024 guidance lists as one option for higher-risk patients. If that happens, it's a precaution, not a sign that something is wrong. And if the team decides to postpone, ask what has to change for a new date to go ahead and how the clinic's rescheduling terms apply. Our guide to paying a cosmetic surgery deposit covers why those terms should be in writing before you travel.

A quick decision path

• Recently started or just increased your dose? Talk to your prescriber and the clinic before choosing dates; the escalation phase is a reason to wait.
• Stable dose, no stomach symptoms? The 2024 guidance suggests many people in this group can continue, but the anesthesiologist decides.
• High dose or ongoing GI symptoms? Expect extra precautions such as a liquid diet the day before, and possibly a different date.
• Still losing weight quickly? Ask the surgeon whether waiting for a plateau would give a more lasting result.