Key Takeaway:
- Nutritional deficiencies increased: 10.2% of youth had a deficiency or related complication within six months of starting GLP-1 treatment, rising to 16.8% after one year.
- Vitamin D deficiency led: It affected 12.4% of patients within one year, followed by nutritional and iron-deficiency anemia.
- Earlier nutrition care may help: Only 5.8% received nutrition care within 30 days, prompting researchers to call for proactive monitoring during treatment.
GLP-1 Nutritional Deficiencies were diagnosed in a growing proportion of children and adolescents during their first year of treatment, according to a new U.S. study.
Study Tracks Deficiencies After GLP-1 Treatment
Researchers analyzed administrative claims data from 2017 through 2022 covering more than 100 million patients and identified 2,031 children and adolescents ages 10 to 17 who had recently started a GLP-1 receptor agonist and had no recorded nutritional deficiency in the previous six months. The study was published Sept. 17 in the journal Childhood Obesity.
The study found that GLP-1 Nutritional Deficiencies and related complications were diagnosed in 10.2% of patients within six months of starting treatment. That figure rose to 16.8% within one year.
The patients had an average age of 15, and 61.5% were female. Liraglutide accounted for 78.6% of prescriptions, followed by dulaglutide at 10.4% and semaglutide at 9.1%.
Vitamin D deficiency was the most frequently diagnosed problem, affecting 12.4% of patients within one year. Nutritional anemia was diagnosed in 1.55%, iron-deficiency anemia in 1.44%, and muscle loss in 0.8%.
The researchers cautioned that the claims-based study cannot establish that GLP-1 treatment caused the deficiencies. The data also relied on diagnosis and billing codes rather than laboratory measurements or detailed clinical notes.
Researchers Cite Nutrition Needs During Adolescence
GLP-1 receptor agonists are increasingly used among young people for conditions including obesity, prediabetes and type 2 diabetes. Because the medications can reduce appetite and food intake, researchers examined whether nutritional problems emerged after treatment began.
Justin Ryder, a senior author and associate professor of surgery and pediatrics at Northwestern University Feinberg School of Medicine, said vitamin D, iron and calcium deserve particular attention during adolescence.
“As appropriate pediatric use of GLP-1s becomes more widespread, we need to understand the risks during periods of rapid growth and pubertal development,” Ryder said. He said deficiencies could have implications for skeletal health and overall development.
The researchers found that nutritional care was uncommon during treatment. Only 5.8% of patients had a nutrition visit within 30 days of starting a GLP-1 drug, while 23.3% had received nutrition therapy or counseling within six months. The average time to the first nutrition visit was 149 days.
Study Calls for Earlier Nutrition Support
Patients who received nutrition counseling had higher rates of diagnosed nutritional deficiencies than those who did not — 23.2% compared with 14.8% after one year. Researchers said this does not indicate that counseling caused the deficiencies, because patients may have been referred after a deficiency was detected or may have received more thorough screening.
Ryder said nutrition support should begin when GLP-1 treatment starts, with proactive monitoring for GLP-1 Nutritional Deficiencies rather than waiting for problems to appear.
“We hope that our study findings bring much-needed recognition to the importance of proactive nutritional management when GLP-1s are prescribed to children,” Ryder said.
Sukhi Basra, vice chair of the National Pharmacy Association, who runs a weight-management clinic, said the findings add to concerns about nutritional monitoring during GLP-1 treatment, while noting that prescribing rules differ between countries.
The researchers concluded that integrating nutrition therapy and counseling into pediatric GLP-1 treatment could help support healthy growth and long-term outcomes. They also called for further research designed to determine whether the medications directly contribute to nutritional deficiencies.
