What is the best plan for preoperative weight loss therapy?

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

Is compounded Semaglutide appropriate as bridge therapy?

Yes, GLP-1 (glucagon-like peptide-1) receptor agonists like Semaglutide are effective for preoperative weight loss and glycemic control, potentially improving surgical outcomes. However, compounded Semaglutide is not FDA-approved (food and drug administration), which raises concerns about dosage consistency and safety.

When should Semaglutide be discontinued before surgery?

It is recommended to stop Semaglutide at least two weeks before surgery to minimize the risk of:

1. Gastroparesis and delayed gastric emptying can increase the risk of aspiration under anesthesia.

2. Severe nausea and vomiting post-op can affect hydration and nutrient intake.

How might it affect post-surgical outcomes?

Benefits:

1. Reduces preoperative weight, lowering surgical risks.

2. Improves diabetes control (with an A1C of 9.1 %, this is particularly important), reducing the risk of post-op complications.

Potential risks:

1. Increased post-op gastrointestinal side effects like nausea, reflux, and vomiting.

2. Nutritional deficiencies, especially when combined with bariatric-induced malabsorption.

3. Delayed gastric emptying may worsen post-op tolerance of oral intake.

Best approach:

1. Switch to FDA-approved Semaglutide (for example., Wegovy or Ozempic) for reliable dosing if possible.

2. Taper off two to four weeks before surgery to minimize anesthesia risks.

3. Monitor diabetes closely during the taper to prevent glucose spikes.

4. Consider restarting Semaglutide at a low dose post-op, but only once oral intake stabilizes.

Would you like guidance on alternative pre-op weight loss strategies if Semaglutide needs to be stopped sooner?

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.