Background and Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly prescribed for obesity and type 2 diabetes mellitus. While these agents provide substantial metabolic benefits, concerns have emerged regarding their effects on nutritional status and potential implications for perioperative outcomes. Materials and Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines. A structured literature search was conducted from 2 May 2026 to 8 June 2026 examining GLP-1RA therapy, nutritional status, body composition and surgical outcomes. Eligible studies included investigations of postoperative outcomes associated with GLP-1RA use, nutritional and body composition effects of GLP-1RAs, associations between nutritional abnormalities and surgical outcomes, and perioperative nutritional optimisation strategies. Data were extracted and synthesised narratively. Results: Twenty studies met the inclusion criteria. Four major themes were identified: (1) nutritional and body composition changes associated with GLP-1RA therapy, (2) effects of malnutrition, sarcopenia, myosteatosis and micronutrient deficiencies on surgical outcomes, (3) postoperative outcomes associated with GLP-1RA use, and (4) perioperative nutritional assessment and optimisation strategies. GLP-1RA therapy was consistently associated with reduced energy intake, inadequate protein intake, micronutrient deficiencies and loss of lean body mass. These abnormalities overlap with recognised risk factors for adverse postoperative outcomes. Despite this, clinical studies generally reported neutral or favourable postoperative outcomes among GLP-1RA users, particularly in arthroplasty and hand surgery populations, although increased wound-healing complications were reported in selected plastic surgery cohorts. Conclusions: Current evidence suggests that GLP-1RAs do not consistently worsen postoperative outcomes; however, their use is associated with nutritional and body composition changes that may influence perioperative recovery. Nutritional assessment and optimisation may therefore represent an important component of perioperative care in patients receiving GLP-1RA therapy.
