Impact of Obesity Medications on Gastric Function

Anti-Obesity Medications (AOM) include multiple classes of medications that can be used for the treatment of obesity which can be categorized as first generation, second generation and third generation AOM. First and Second generation AOM’s were used in a limited number of patients in clinical practice, but the introduction of the third generation of AOMs—semaglutide and tirzepatide, glucagon-like peptide-1 receptor agonist (GLP1-RA) and dual GLP-1/glucose-dependent insulinotropic polypeptide receptor agonist (GIP-RA), respectively, has led to significantly higher obesity treatment with AOMs. These medications are significantly more effective than first and second generation AOMs, however, they also have significant effects on gastrointestinal motility. This has led to a broader discussion on the use of these medications in patients undergoing anesthesia for surgical or endoscopic procedures. In this review we discuss the full-spectrum of anti-obesity medications, their impact on gastric motility, data on clinical outcomes in patients undergoing endoscopic procedures on GLP-1 RA and the current landscape of medical society guidelines for patients on GLP-1 RA undergoing endoscopic procedures.