The evidence base for GLP-1 receptor agonist safety is reassuring over 2–3 year horizons but genuinely insufficient to characterize long-term (5+ year) risks, and the most credible remaining concerns — gallbladder events, lean mass loss in older adults, and weight regain on discontinuation — are specific, manageable, and distinct from the headline fears (thyroid cancer, generalized muscle wasting) that dominate public discourse.

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The evidence base for GLP-1 receptor agonist safety is reassuring over 2–3 year horizons but genuinely insufficient to characterize long-term (5+ year) risks, and the most credible remaining concerns untested-default

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