One in Five GLP-1 Drug Users Had Retained Food in Their Stomach During Endoscopy Procedures | Research

The takeaway

About 20.6% of patients on GLP-1 receptor agonists had retained gastric content during upper endoscopy, though severe complications were rare.

20.6% had retained gastric content
One in five patients on GLP-1 drugs still had food or liquid in their stomachs during upper endoscopy despite standard fasting

What the researchers found

Among 218 adults on GLP-1 receptor agonists undergoing upper endoscopy, retained gastric content (RGC) was observed in 20.6% of patients. Nine procedures were terminated prematurely due to retained content. One aspiration event and one intraprocedural intubation occurred. Despite the high prevalence of retained stomach content, the overall incidence of severe complications or adverse outcomes was low.

Why it matters

With millions of people now taking GLP-1 drugs like semaglutide and liraglutide, understanding their impact on routine medical procedures is critical for patient safety. GLP-1 drugs slow stomach emptying, which means standard fasting instructions before endoscopy may not be sufficient. This data helps gastroenterologists and anesthesiologists plan safer procedures for this growing patient population.

How the study worked

Retrospective cohort study of 218 adults taking GLP-1 receptor agonists who underwent esophagogastroduodenoscopy (upper endoscopy) between June 2013 and June 2023 at Baylor Scott & White Health system. Researchers analyzed the frequency of retained gastric content and related adverse events.

What this study cannot tell us

This was a retrospective study at a single health system, which may limit generalizability. There was no control group of non-GLP-1 users for direct comparison of RGC rates. The study did not differentiate between specific GLP-1 drugs or doses, and did not assess whether patients followed modified fasting protocols. The 10-year time span means practice patterns and available drugs changed during the study period.

How to read the evidence

This is a retrospective cohort study from a single health system with a moderate sample size of 218 patients. While it provides useful real-world data, it lacks a control group and cannot establish causation between GLP-1 use and retained gastric content.

When this study was published

Published in 2026 with data spanning 2013–2023, this study captures a decade of experience with GLP-1 drugs and endoscopy, making it timely given the explosion in GLP-1 prescribing.

The bigger picture

As GLP-1 receptor agonists become among the most prescribed medications globally, their side effects and interactions with other medical procedures are increasingly important. Several anesthesiology and gastroenterology societies have already issued guidance on managing GLP-1 users before procedures. This study adds real-world data to that evolving conversation about preprocedural protocols.

Questions still open

Should fasting guidelines be extended or modified specifically for patients taking GLP-1 receptor agonists before endoscopy?
Do different GLP-1 drugs (e.g., semaglutide vs. liraglutide) carry different levels of risk for retained gastric content?
Would point-of-care gastric ultrasound before endoscopy reduce procedural complications in GLP-1 users?

Common questions

Should I stop my GLP-1 medication before an endoscopy?

This study found that about 20% of GLP-1 users had food retained in their stomachs during endoscopy. While severe complications were rare, you should discuss your medication schedule with your doctor before any procedure. Some guidelines now recommend holding GLP-1 drugs for a period before procedures requiring sedation.

Why do GLP-1 drugs cause food to stay in the stomach longer?

GLP-1 receptor agonists work partly by slowing gastric emptying — the rate at which food leaves your stomach. While this helps with blood sugar control and reduces appetite, it means standard fasting instructions may not fully empty the stomach before procedures, increasing the risk of aspiration.

Read the original research

Impact of GLP-1 receptor agonists on gastric residuals in patients receiving gastrointestinal endoscopic procedures.

Proceedings (Baylor University. Medical Center), 39(1), 25-28

View on PubMed ↗Publisher’s paper ↗

Citation

Le, Kim; Prasad, Sanjay; Shah, Rajesh. (2026). Impact of GLP-1 receptor agonists on gastric residuals in patients receiving gastrointestinal endoscopic procedures.. Proceedings (Baylor University. Medical Center), 39(1), 25-28. https://doi.org/10.1080/08998280.2025.2583025