Liver transplant recipients using GLP-1 receptor agonists achieved significant weight reduction of 3.8 kg and BMI decreases of 1.6 kg/m² over one year, alongside meaningful glycemic control improvements with HbA1c dropping 0.48%. The 104-patient multicenter study found subcutaneous semaglutide at median doses of 0.82 mg weekly maintained stable liver function and immunosuppression levels without treatment-limiting adverse events. This represents crucial progress for a vulnerable population where post-transplant weight gain threatens long-term survival through cardiovascular complications and organ rejection. The safety profile is particularly noteworthy given transplant recipients' complex medication regimens and immunocompromised status. However, the weight loss magnitude—while statistically significant—remains modest compared to outcomes seen in general populations using higher GLP-1 doses. The observational design and relatively low dosing limit definitive conclusions about optimal protocols. Still, these findings address a critical unmet need, as post-transplant metabolic dysfunction affects most liver recipients and significantly impacts graft longevity. The demonstrated compatibility with immunosuppressive therapy opens pathways for larger randomized trials that could establish GLP-1 agonists as standard post-transplant care.