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

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are now used widely to manage diabetes, obesity, and an expanding set of metabolic and cardiorenal conditions. As prescribing grows in younger, healthier, and more diverse populations, clinicians increasingly require practical guidance that balances therapeutic benefit with individualized safety considerations. This review synthesizes the current evidence on the physiological mechanisms, clinical indications, and practical safety considerations of this drug class. We aim to provide a structured, clinically oriented approach to monitoring and managing adverse effects, with emphasis on gastrointestinal intolerance, supported by an algorithm for early symptom management. Finally, we outline communication strategies that support shared decision-making, reduce stigma, and align therapy with patient goals. This framework aims to help clinicians deliver safe, informed, and patient-centered care as GLP-1-based therapies continue to evolve. Funding: This study received no external funding.