Cons of Using GLP-1 Receptor Agonists for Weight Management

Gastrointestinal Side Effects

The most common adverse effects of GLP-1 receptor agonists are gastrointestinal disturbances including nausea, vomiting, diarrhea, dyspepsia, constipation, and gastrointestinal reflux, which are dose-dependent and more frequent with short-acting than long-acting formulations 1

GLP-1 receptor agonists significantly delay gastric emptying, posing substantial risks for patients undergoing surgical procedures, and current guidelines recommend holding GLP-1 receptor agonists for at least three half-lives before procedures 2
For patients taking GLP-1 receptor agonists for weight loss, the risks may outweigh the benefits in the perioperative period, and even discontinuing long-acting formulations for 7 days may not be sufficient to ensure an empty stomach pre-operatively 2
Current guidelines recommend holding GLP-1 receptor agonists for at least three half-lives before procedures, which would be 3 weeks for semaglutide, to minimize risks 3

Weight loss induced by GLP-1 receptor agonists may include loss of muscle mass, not just fat tissue, which can negatively impact functional status and metabolic health, particularly in older adults 4