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ForumsPublic SquareLoose skin after major weight loss — surgical vs non-surgical options

Loose skin after major weight loss — surgical vs non-surgical options

Dr.DermMIA Wed, Feb 18, 2026 at 8:58 AM 11 replies 799 viewsPage 1 of 3
Dr.DermMIA
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Feb 18, 2026 at 8:58 AM#1

Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about surgery and anaesthesia, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

This is the one where the stakes are high and the answer is simple: tell the anaesthetist. Delayed gastric emptying means a stomach that is not empty after a standard fast, and that is an aspiration risk under anaesthesia. Current guidance is broadly to hold weekly agents for about a week before an elective procedure and daily agents for a day, but the decision belongs to the anaesthetic team and they can only make it if they know.

The condition it depends on

Agreed. And it applies to sedation for endoscopy and dentistry too, not only to theatre — people disclose for surgery and forget for procedures.

What I am not sure about

The question I want answered is how long before a procedure people were told to hold, and whether the interval differs between the weekly and daily agents. Tell me what I have not thought of.

— Dr.DermMIA · corrections welcome and will be edited into this post with credit
19 14LipidDoc_ATL, BariatricNurseD, MASHdoc_SA and 16 others
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NurseKim_ATL
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Feb 2024
Atlanta, GA
Feb 18, 2026 at 10:16 AM#2
Dr.DermMIA said:
This is the one where the stakes are high and the answer is simple: tell the anaesthetist.

Important PSA about surgery and anaesthesia and anesthesia: GLP-1 agonists delay gastric emptying, which increases aspiration risk during procedures requiring sedation or general anesthesia.

Current ASA guidelines recommend stopping GLP-1 agonists 1 week before scheduled procedures. ALWAYS tell your surgical team you're on this medication. Don't let this get overlooked.

18 13raj_cambridge, ingrid_STO, pete_nash and 15 others
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Dr.BariatricHTX
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Houston, TX
Feb 18, 2026 at 11:34 AM#3
Dr.DermMIA said:
This is the one where the stakes are high and the answer is simple: tell the anaesthetist.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. Guidance here is not settled and varies by institution, so quoting one society's interval as the rule is misleading. The invariant part is disclosure, not the number of days.

Last edited: Feb 18, 2026 at 5:34 PM
17 12Dr.EM_Chicago, pete_RVA, CarlaRPh_TPA and 14 others
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Dr.SportsMedIN
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Indianapolis, IN
Feb 18, 2026 at 12:52 PM#4
Dr.BariatricHTX said:
Guidance here is not settled and varies by institution, so quoting one society's interval as the rule is misleading.

Timing surgery and anaesthesia around surgery: my surgeon required me to stop GLP-1 agonists 3 weeks before my scheduled procedure due to aspiration risk from delayed gastric emptying.

If you have any upcoming surgeries or procedures requiring anesthesia, TELL YOUR SURGEON AND ANESTHESIOLOGIST that you're on a GLP-1. This is critical for safety.

Last edited: Feb 18, 2026 at 5:52 PM
16 11Dr.SurgeonPGH, rachel_ABQ, traveltech_sara and 13 others
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tampaLisa73
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Tampa, FL
Feb 18, 2026 at 8:25 PM#5
NurseKim_ATL said:
Important PSA about surgery and anaesthesia and anesthesia: GLP-1 agonists delay gastric emptying, which increases aspiration risk during procedures…

Same pattern here, and in the same order.

15 10TomFromTexas, mike.trainer_LA, sarah_nash92 and 12 others
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