Vitamin D deficiency was the most frequently identified problem, affecting 12.4% of children within one year of beginning GLP-1 therapy.

Nutrition Matters During Childhood Growth

"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 author Justin Ryder, PhD, Vice Chair of Research for 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. "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."

Adolescence is a period when the body requires substantial nutritional support for bone growth, physical development, and other major biological changes. Because GLP-1 medications can affect appetite and food intake, researchers say attention to nutrition may be especially important for younger patients receiving these drugs.

"Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated," he added. "In our study, however, we found that only 5% of patients received nutritional counseling within 30 days of GLP-1 treatment and less than 25% received nutritional counseling within 6 months."

Tracking GLP-1 Use in More Than 2,000 Children

To investigate the issue, Dr. Ryder and his colleagues analyzed national administrative claims data collected from 2017 through 2022. The broader database covered more than 100 million patients.

From those records, the researchers identified 2,031 GLP-1 users ages 10 to 17 who met the study's continuous enrollment requirements and had not previously been diagnosed with a nutritional deficiency.

Among these children, liraglutide (Victoza and Saxenda) was by far the most commonly prescribed GLP-1 medication, accounting for 78.6% of prescriptions. Dulaglutide (Trulicity) accounted for 10.4%, while semaglutide (Ozempic and Wegovy) accounted for 9.1%.

Researchers Call for Earlier Nutritional Support

The findings suggest that nutritional care may need to begin alongside GLP-1 treatment rather than only after a deficiency has already been detected.

"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 Dr. Ryder. "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."