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However, some patients may benefit from temporary discontinuation, particularly those: In the dose-escalation phase Experiencing significant gastrointestinal symptoms With known gastroparesis or other conditions affecting gastric emptying With obesity complicated by GERD or hiatal hernia Undergoing procedures with higher aspiration risk For these higher-risk patients on once-weekly injectable semaglutide , some clinicians recommend discontinuation approximately one week (7 days) before elective surgery