GLP-1 receptor agonists and glucose-dependent insulinotropic polypeptide demonstrate mortality reduction in chronic liver disease patients both before and after liver transplantation, while effectively promoting weight loss in those with obesity and visceral sarcopenic obesity. The drugs also prevent disease progression in metabolic dysfunction-associated steatotic liver disease. This represents a significant therapeutic breakthrough for a patient population where malnutrition, frailty, and sarcopenia are endemic complications that traditionally worsen outcomes. The mortality benefit is particularly noteworthy given that liver transplant candidates and recipients face exceptionally high mortality risks. However, the findings warrant cautious optimism. The review highlights a critical concern: GLP-1 agonists may paradoxically worsen or trigger new sarcopenia, the very muscle wasting condition that devastates liver disease patients. This creates a complex risk-benefit calculation where the drugs' metabolic benefits must be weighed against potential muscle loss. The lack of randomized controlled trial data specific to liver disease populations means these observations, while promising, remain preliminary. The concurrent exploration of bariatric interventions suggests the field is aggressively pursuing multiple therapeutic avenues for what has historically been a nutritionally intractable patient population.