Purpose of Review <p>The aim of the review is to evaluate the benefits and limitations of GLP-1 receptor agonists, with particular emphasis on adverse effects, unresolved safety issues, and the socioeconomic and ethical aspects of their growing popularity.</p> Recent Findings <p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the management of type 2 diabetes mellitus (T2DM) and obesity, offering clinically significant improvements in glycemic control, weight reduction, and cardiometabolic outcomes, with additional benefits reported for renal outcomes in patients with chronic kidney disease. Beyond these indications, emerging evidence suggests potential benefits in conditions such as metabolic-associated steatotic liver disease and obesity-related comorbidities including obstructive sleep apnea. Their widespread use, however, has been accompanied by growing attention to side effects, long-term safety concerns, and ethical challenges. Common adverse effects are primarily gastrointestinal and transient, though more severe complications, including gallbladder disease, bowel obstruction, retinopathy, and rare neoplasms, have been reported. Neuropsychiatric symptoms and post-discontinuation weight regain are additional concerns that complicate long-term management. Furthermore, off-label use for cosmetic weight loss has contributed to drug shortages, inequitable access, and increased circulation of counterfeit products, raising serious public health and ethical issues.</p> Summary <p> Future directions should prioritize robust pharmacovigilance, structured discontinuation protocols, and research into biomarkers of responsiveness. GLP-1 RAs should be repositioned within lifecycle-based, personalized care models, integrating pharmacotherapy with sustainable lifestyle and behavioral interventions. Such an approach will be essential to maximize therapeutic benefit, minimize risk, and ensure equitable use of these powerful yet imperfect agents.</p>