Balancing the benefits and risks of GLP-1 receptor agonists: a clinical guide for shared decision-making.

This clinical review synthesizes current evidence on glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a drug class increasingly used to manage type 2 diabetes, obesity, and expanding metabolic and cardiorenal conditions. The authors describe the physiological mechanisms underlying GLP-1 RA action, survey established and emerging clinical indications, and outline practical safety considerations relevant to growing use in younger, healthier, and more diverse patient populations. A central focus is the management of adverse effects—particularly gastrointestinal intolerance—for which the authors propose a structured algorithm to guide early symptom management in clinical practice. The review also addresses communication strategies intended to support shared decision-making, reduce weight-related stigma, and align therapy with individual patient goals and values. As a narrative review without original data collection, the paper does not generate new clinical outcome data and is subject to the selection biases inherent to non-systematic literature reviews. Nonetheless, it offers a clinically oriented framework intended to help practitioners translate evolving GLP-1 RA evidence into individualized, patient-centered care. No external funding was reported.

Why this grade: This is a narrative clinical review that synthesizes existing literature rather than generating original data, so it is graded as review-level evidence regardless of the quality of the underlying studies it draws upon.