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GLP-1 Receptor Agonists and Aspiration Risk: From Universal Holding to Risk-Based Perioperative Management Review Abstract Purpose The rapid adoption ofglucagon-like peptide-1 receptor agonists (GLP-1 RAs)anddual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GIP/GLP-1) receptor agonistshas transformed the management of type 2 diabetes mellitus and obesity

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GLP-1 agonists may: Optimize high-risk patients before surgery Improve metabolic control Potentially reduce surgical risk But durable long-term outcomes in severe obesity still rely heavily on: Surgical intervention Lifelong follow-up Nutritional monitoring Multidisciplinary care The future may not be medicine vs surgery. It may be the intelligent integration of both