GLP-1 weight-loss and diabetes drugs tied to nutrient deficiencies in 1 in 6 kids

MALAYSIA, KUALA LUMPUR, SELANGOR, SOUTHEAST ASIA, CHICAGO (ANN & ROBERT H. LURIE CHILDREN’S HOSPITAL), 24 SEPTEMBER 2026 —

Nearly 1 in 6 Children on GLP-1 Drugs Develop Nutritional Deficiencies Within a Year, Study Finds

Children prescribed GLP-1 medications—such as Victoza, Saxenda, Trulicity, and Ozempic—for weight loss, prediabetes, or type 2 diabetes face a significant and underrecognized risk: nearly one in six develop a diagnosed nutritional deficiency within their first year of treatment, according to a new study published in Childhood Obesity.

The findings raise urgent questions about pediatric monitoring and nutritional support as GLP-1 use expands among young patients, particularly in Malaysia and Southeast Asia, where obesity and diabetes rates among adolescents are rising.

The study, led by researchers at Ann & Robert H. Lurie Children’s Hospital of Chicago, highlights vitamin D deficiency as the most common issue, affecting 12.4% of children within 12 months of starting GLP-1 therapy.

With appetite suppression and altered food intake among the known side effects of these drugs, experts warn that deficiencies in critical nutrients like iron and calcium could have lasting consequences for skeletal health and development during adolescence—a period already marked by rapid physical and cognitive growth.

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The research, published in Childhood Obesity, analyzed national administrative claims data from over 100 million patients between 2017 and 2022, focusing on 2,031 children aged 10 to 17 who had no prior nutritional deficiency diagnoses. Among them, 16.8% were diagnosed with at least one deficiency within a year of beginning GLP-1 treatment. Vitamin D deficiency led the list, followed by deficiencies in iron, calcium, and other essential nutrients.

Liraglutide (marketed as Victoza and Saxenda) was the most prescribed GLP-1 medication among the study group, accounting for 78.6% of prescriptions, while dulaglutide (Trulicity) made up 10.4% and semaglutide (Ozempic and Wegovy) 9.1%. The data shows a critical gap in clinical practice: only 5% of patients received nutritional counseling within 30 days of starting treatment, and fewer than 25% had such guidance within six months.

“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 Justin Ryder, PhD, senior author of the study, Vice Chair of Research for the Department of Surgery at Lurie Children’s Hospital, and Associate Professor of Surgery and Pediatrics at Northwestern University Feinberg School of Medicine.

“Nutrients such as vitamin D, iron, and calcium are of particular concern during adolescence, when deficiencies may have lasting implications for skeletal health and overall development.”

Ryder emphasized that GLP-1 medications, while effective for weight management and diabetes control, can reduce appetite and alter eating patterns, potentially leading to inadequate nutrient intake. “Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated,” he stated. “However, our study found that proactive nutritional care is often delayed—sometimes until after a deficiency has already been diagnosed.”

The findings align with growing concerns in Malaysia, where obesity rates among children have surged in recent years. According to the National Health and Morbidity Survey (NHMS) 2019, nearly 15% of Malaysian children aged 5 to 17 were classified as overweight or obese, with urban areas like Kuala Lumpur and Selangor reporting higher prevalence.

The rise in pediatric diabetes cases—type 2 diabetes now accounts for up to 45% of all diabetes diagnoses in Malaysian children, per the Malaysian Society for Paediatric Endocrinology and Diabetes (MSPED)—has led to increased off-label use of GLP-1 drugs in adolescents, despite limited long-term safety data.

In Southeast Asia, where dietary habits often lack sufficient micronutrients, the risk of deficiencies may be even higher. A 2023 study in the Journal of Clinical Endocrinology & Metabolism found that vitamin D deficiency affects over 80% of Malaysian adolescents, partly due to limited sun exposure and poor dietary intake. The new GLP-1 study suggests that without targeted nutritional interventions, children on these medications could face compounded risks.

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The study’s authors stress that nutritional deficiencies in adolescence are not benign. Vitamin D deficiency, for instance, has been linked to weakened bone density, increased fracture risk, and long-term metabolic dysfunction. Iron deficiency can impair cognitive development and physical stamina, while calcium deficiencies may stunt growth. “Knowing the risks, we are in a much better position to prevent harm to children treated with GLP-1s during a period in their lives,” Ryder said.

Yet, the data reveals a systemic failure in preventive care. Only a fraction of patients received early nutritional guidance, despite guidelines from organizations like the American Academy of Pediatrics (AAP) recommending regular monitoring of micronutrient levels in children on weight-loss medications. In Malaysia, where pediatric endocrinologists often operate with limited resources, the lack of standardized nutritional protocols for GLP-1 users could exacerbate the problem.

The Malaysian Ministry of Health (MOH) has not yet issued specific directives on nutritional monitoring for children prescribed GLP-1 drugs, though it has previously warned about the off-label use of these medications in minors. A spokesperson for the MOH told DomainFork that the agency is reviewing the latest international research on GLP-1 safety in pediatrics but declined to comment on immediate policy changes.

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For parents and caregivers, the study serves as a cautionary note. While GLP-1 medications offer promising benefits for obesity and diabetes management, their use in children must be accompanied by rigorous nutritional oversight. Experts recommend that patients undergo baseline micronutrient testing before starting treatment, followed by regular follow-ups to assess vitamin D, iron, calcium, and other key levels.

“Proactive nutritional management should be integrated into GLP-1 treatment plans from the outset,” Ryder said. “This isn’t just about treating deficiencies after they occur—it’s about preventing them before they impact a child’s health.”

The study’s findings come as global regulators, including the U.S. Food and Drug Administration (FDA), continue to evaluate the long-term safety of GLP-1 drugs in pediatric populations. In Malaysia, where pharmaceutical access is expanding, the lack of localized data on nutritional risks adds another layer of uncertainty for clinicians.

As the debate over GLP-1 use in children intensifies, one thing is clear: without immediate action to address nutritional gaps, the benefits of these drugs may be outweighed by preventable health consequences for a generation of young patients.

Related: Justin Ryder, PhD