News · Heart & Metabolic
GLP-1 drugs in teens: 1 in 6 had a nutrient deficiency diagnosed within a year
Weight-loss and diabetes injections cut appetite, and that raises a question for growing bodies. Insurance records of 2,031 US teenagers found frequent deficiencies and little nutrition support.
- An analysis of US insurance claims for 2,031 people aged 10 to 17 who started a GLP-1 drug.
- Most took liraglutide; the average age was 15, and 62.6% had obesity.
- Within a year, 16.88% were diagnosed with a nutritional deficiency or related complication.
- Vitamin D deficiency was the most common, at 12.4%; anemia affected under 2% each.
- Only 23.3% saw a nutrition professional within six months, and there was no comparison group.
GLP-1 drugs work largely by making people less hungry. In adults that is the point. In teenagers who are still growing, eating much less raises a question that has had little data behind it: do they get enough vitamins and minerals?
A study in the journal Childhood Obesity looked at insurance records for 2,031 US teenagers who started one of these drugs. About one in six was diagnosed with a nutritional deficiency within a year, and fewer than a quarter saw a nutrition professional within six months.
Why nutrients matter for growing teenagers
Vitamin D was the deficiency found most often, and MedlinePlus explains why it matters: it helps your body absorb calcium, one of the main building blocks of bone, and a lack of vitamin D can lead to bone diseases such as osteoporosis or rickets. The teenage years are when most adult bone is laid down.
The drugs are being prescribed more to young people. As the authors note, GLP-1 receptor agonists are increasingly used to treat childhood obesity, prediabetes, and type 2 diabetes, yet how often nutritional problems follow had not been measured in this age group.
How the teen GLP-1 study was done
The researchers used Inovalon, a database of insurance claims covering more than 100 million people from 2017 to 2022. They found 2,031 GLP-1RA users aged 10-17 years who had been continuously insured and had no deficiency diagnosis before starting.
They then looked for diagnosis codes for nutritional deficiencies in the year after the first prescription, and for visits for nutrition therapy or counseling. The average patient was 15, most were girls, and liraglutide was by far the most common drug, reflecting the years covered.
What happened to nutrient levels
Deficiencies were common. Within 1 year, 16.88% of patients were diagnosed with at least one nutritional deficiency or related complication. Vitamin D deficiency led at 12.4%, with anemia from poor nutrition and iron-deficiency anemia each affecting under 2%.
Nutrition support was patchy. Only 23.3% had NT/C visit within 180 days, meaning nutrition therapy or counseling, and the average wait for a first visit was about five months. Teenagers who did get such visits had more deficiencies recorded, 23.2% against 14.8%, which most likely reflects that seeing a dietitian leads to testing.
Why nutrition support belongs in GLP-1 care
Smaller meals leave less room for protein, vitamins and minerals, and adolescents are still growing, so the stakes are arguably higher than in adults. The authors conclude that nutritional deficiencies are a meaningful and under-recognized risk in young users.
The low rate of nutrition visits is the more actionable finding. It suggests many teenagers start these drugs without anyone planning how they will eat enough of the right things, a gap the authors describe as a missed opportunity for proactive and preventive support.
What a teen GLP-1 claims study cannot show
There was no comparison group. Vitamin D deficiency is common among teenagers with obesity whether or not they take these drugs, so the study cannot say how many deficiencies the drugs caused. Claims also record only what doctors diagnosed and billed; untested teenagers with low levels appear healthy in this data.
The data end in 2022, when liraglutide dominated, and newer drugs such as semaglutide and tirzepatide tend to produce more weight loss. The study cannot say whether deficiencies affected growth, bone health or anything else.
What this changes for teens starting GLP-1 drugs
For parents of a teenager starting a GLP-1 drug, the practical questions are simple: who will advise on eating, will vitamin D and iron be checked, and how will growth be followed? Meals built around protein, dairy or fortified alternatives, fruit, vegetables and whole grains matter more when the total amount eaten falls.
For clinicians and health services, the study is a prompt to build nutrition support into prescribing from the start, rather than months later or not at all.
People also ask
What did the study find?
Within one year of starting a GLP-1 receptor agonist, 16.88% of patients were diagnosed with at least one nutritional deficiency or deficiency-related complication, most often vitamin D deficiency (12.4%), then nutritional anemia (1.55%) and iron-deficiency anemia (1.44%). Only 23.3% had a nutrition therapy or counseling visit within 180 days, with a mean of 149 days to the first visit.
Which drugs were involved?
Liraglutide in 78.6% of patients, dulaglutide in 10.4% and semaglutide in 9.1%. The data ran from 2017 to 2022, before semaglutide became widely used in teenagers.
Does this prove GLP-1 drugs cause deficiencies?
No. The study had no comparison group of teenagers not taking the drugs, and vitamin D deficiency is common in teenagers with obesity anyway. It shows how often deficiencies were diagnosed, not how many the drugs caused.
Why did teens who saw a dietitian have more deficiencies?
Those with nutrition visits had higher rates, 23.2% against 14.8%. The likeliest explanation is that nutrition visits lead to testing, which finds deficiencies that would otherwise go unrecorded.
Why does nutrition matter more for teenagers?
Adolescents are still growing and building bone. Eating much less, as these drugs encourage, can make it harder to get enough protein, calcium, iron and vitamin D.
What should parents ask about?
Whether the plan includes nutrition advice, checks on vitamin D and iron, and follow-up on growth. This is general information rather than medical advice.