Background

The glucagon like peptide-1 (GLP-1) agonists have become popular medications for use in diabetes management and as an adjunct for weight loss. The impact of these medications on pre-operative patients, specifically regarding the risks associated with anesthesia administration and food retention was previously unknown. This study evaluates the impact of GLP-1 agonists on disrupting an esophagogastroduodenoscopy (EGD) due to food retention in pre-bariatric patients.

Methods

The research group consisted of 576 adult patients who had an EGD within one year of bariatric surgery during years 2019 to 2023. Study groups included those who used a GLP-1 agonist within ninety days of their EGD (n=45) and those who had no use of GLP-1 agonist for one year prior to EGD (n=531).

Results

The primary outcome evaluated was food retained in the stomach as evidenced by EGD. The study cohort included 83% female, mean age 42.8 years, mean BMI 46.2 kg/m2, and 27% had diabetes. Of the 576 EGDs, there were 5.6%. Percent with food retained in the stomach was higher in the GLP-1 group (16% vs 3%, p=0.0008). When adjusted for age, sex, race/ethnicity, BMI, and diabetes, those with GLP-1 use were 5.8 times more likely to have food in stomach (OR=5.81, 95% CI=[1.95, 17.31], p=0.0016).

Conclusions

This study confirms that newly updated guidelines for pre-operative diet restrictions within patients taking GLP-1 agonists are appropriate.