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Nearly 1 in 6 Kids on GLP-1s Developed This Problem Within a Year

Many kids who take these drugs aren't given dietary counseling, a recent study suggests.
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The growing trend of children and teens using GLP-1 medications like Ozempic isn’t completely without its risks. Recent research shows that young people are sometimes developing nutritional deficiencies after they start taking one of these drugs.

Scientists at Northwestern University Feinberg School of Medicine and others examined the medical records of children and teens who went on a GLP-1. Almost one in six ended up newly diagnosed with a deficiency, they found. The results suggest that doctors should be keeping a close eye on the nutritional health of kids prescribed these treatments, the researchers say.

“Nutritional deficiencies are a meaningful and underrecognized risk among pediatric patients receiving GLP-1RA therapy,” the authors wrote in their paper, published last week in the journal Childhood Obesity.

An underrecognized risk

Childhood obesity is a serious issue. About 22% of adolescents ages 12 to 19 are obese, according to the latest data from the Centers for Disease Control and Prevention, as are 21% of children ages 6 to 11.

GLP-1 drugs like semaglutide (Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound) have emerged as effective options for obesity and type 2 diabetes, including for children. At the same time, there remains much that we don’t know about the use of these drugs in kids.

In this latest study, the researchers analyzed claims data from a large database of real-world patients. Between 2017 and 2022, they identified roughly 2,000 children ages 10 to 17 who were started on a GLP-1 and had no preexisting deficiency noted in their medical records.

Within a year’s time after going on a GLP-1, they found that about 17% of these children were diagnosed with either a deficiency or a complication related to a deficiency, such as anemia. The most common diagnosis was vitamin D deficiency (12%), followed by nutritional anemia (1.55%) and iron-deficiency anemia (1.44%).

What to take away

This is only an observational study, meaning that the researchers can’t conclusively prove that the children’s GLP-1 use contributed to their later deficiencies. The study also covers a period of time prior to the more widespread adoption of these drugs for children.

Still, research has shown that intentional weight loss in general can increase people’s risk of nutritional deficiency. And other recent studies have shown a similar link between GLP-1 use and nutrition-related problems, including serious, if rare, health conditions caused by certain deficiencies.

Though this study can’t tell us exactly why kids on GLP-1s develop these problems, the researchers do point to potential gaps in the care they got from their doctors. Only about 5% of people in the study were given dietary counseling in the first 30 days after being prescribed a GLP-1, and only a quarter of people received it within six months.

“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,” said study author Justin Ryder, an associate professor of surgery and pediatrics at Northwestern as well as a surgeon at the Ann & Robert H. Lurie Children’s Hospital of Chicago, in a statement from the hospital. “Knowing the risks, we are in a much better position to prevent harm to children treated with GLP-1s during a pivotal period in their lives.”

Notably, the American Academy of Pediatrics began recommending GLP-1 therapy for childhood obesity in 2023—recommendations that also emphasized the importance of providing nutritional support to kids alongside any pharmacological treatments.

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