A meta-analysis of 11 randomized controlled trials found GLP-1 receptor agonists reduced BMI by 1.38 kg/m² in women with PCOS compared to controls, while showing no significant effects on LDL cholesterol or triglycerides. Evidence for improvements in glucose metabolism, insulin sensitivity, hirsutism, and menstrual regularity remained insufficient due to study limitations. This finding adds important nuance to the GLP-1 narrative dominating weight management discussions. While these medications have shown dramatic results in general obesity populations, the modest BMI reduction in PCOS represents a more measured outcome. Given that PCOS affects up to 15% of reproductive-age women and often involves insulin resistance and weight gain that's notoriously difficult to manage, even this incremental improvement could be clinically meaningful. However, the low certainty of evidence and absence of data on psychological outcomes, quality of life, or cost-effectiveness highlights significant knowledge gaps. The lack of robust evidence for metabolic improvements is particularly noteworthy, since insulin resistance is central to PCOS pathophysiology. This represents confirmatory but limited evidence that warrants larger, longer-term studies before definitive clinical recommendations.