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Their widespread use has given rise to concerns regarding rare but potentially serious adverse events. This narrative review appraises evidence regarding seven serious adverse events linked to GLP\u20101 receptor agonists: thyroid cancer, non\u2010arteritic anterior ischaemic optic neuropathy (NAION), suicidal behaviours and self\u2010harm, diabetic retinopathy complications, acute pancreatitis, gallbladder and biliary disease and intestinal obstruction. Evidence from mechanistic studies, spontaneous reports, randomized trials and cohort studies is considered. Gallbladder and biliary disease has the most consistent evidence supporting a causal association. Worsening of diabetic retinopathy appears most consistent with early worsening after rapid glycaemic improvement in patients with pre\u2010existing retinopathy. For thyroid cancer, NAION, suicidal behaviour and self\u2010harm, acute pancreatitis and intestinal obstruction, evidence regarding causality remains uncertain. 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