Nearly one in six children taking GLP-1 medications for weight loss, prediabetes or type 2 diabetes were diagnosed with a nutritional deficiency within a year of starting treatment, according to a new study published in Childhood Obesity.
The analysis found that 16.8% of young patients developed a documented nutritional deficiency during the first year of GLP-1 therapy. Vitamin D deficiency was the most common, affecting 12.4% of patients.
Researchers say the findings highlight the importance of monitoring nutrition when GLP-1 medications are prescribed during childhood and adolescence, when the body requires adequate supplies of nutrients for growth and development.
"As appropriate pediatric use of GLP-1s becomes more widespread, we need to understand the risks during periods of rapid growth and pubertal development," said senior study author Justin Ryder, PhD, Vice Chair of Research in the Department of Surgery at Ann & Robert H. Lurie Children's Hospital of Chicago and Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine.
Vitamin D, iron and calcium may be particularly important during adolescence because deficiencies can affect bone health and overall development. GLP-1 medications can reduce appetite and food intake, potentially making adequate nutrient intake more difficult for some children.
The researchers also found that nutritional counseling was uncommon after treatment began. Only 5% of patients received nutritional counseling within 30 days of starting GLP-1 therapy, while fewer than 25% received such counseling within six months.
Study Included More Than 2,000 Children
Researchers analyzed national administrative health insurance claims collected between 2017 and 2022. The database included information on more than 100 million patients.
The study identified 2,031 GLP-1 users between the ages of 10 and 17 who met the researchers' enrollment criteria and had no diagnosed nutritional deficiencies before treatment.
Liraglutide, marketed as Victoza and Saxenda, was the most frequently prescribed medication, accounting for 78.6% of prescriptions. Dulaglutide (Trulicity) accounted for 10.4%, while semaglutide (Ozempic and Wegovy) represented 9.1%.
The researchers say nutritional assessment and support may need to be incorporated into GLP-1 treatment from the beginning rather than introduced only after a deficiency is identified.
"We hope that our study findings bring much needed recognition to the importance of proactive nutritional management when GLP-1s are prescribed to children, as opposed to waiting until a nutritional deficiency is diagnosed," Ryder said.
The authors noted that identifying potential nutritional risks early could help healthcare providers reduce the likelihood of deficiencies during an important period of childhood development.
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