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Disease modifying agents capable of controlling obesity with meaningful metabolic improvement have reshaped expectations for both clinicians and patients ( Nausea and vomiting remain among the most frequent and disruptive adverse effects across Glucagon-like peptide (GLP-1)-based therapies ( In this opinion article, we examine the mechanisms underlying nausea and vomiting in semaglutide, CagriSema, survodutide, tirzepatide, retatrutide, and orforglipron and situate them within obesity clinical practice ( We also propose practical strategies to mitigate gastrointestinal intolerance