Science for a Healthier Tomorrow
In a claims study of 2,031 youths starting GLP-1 drugs, 16.9% had a recorded nutritional deficiency within a year; 23.3% had a nutrition visit.
An analysis of US administrative claims finds that among 2,031 patients aged 10 to 17 who started GLP-1 receptor agonists, 16.9% had a nutritional-deficiency or related-complication diagnosis recorded within one year. Vitamin D deficiency was by far the most common (12.4% of the cohort); nutritional anemia (1.55%) and iron-deficiency anemia (1.44%) were less frequent. Fewer than one in four patients had a nutrition therapy or counseling visit within 180 days of starting treatment (23.3%); the mean time to a first visit was 149 days.
The study, published online September 17 in Childhood Obesity, is a retrospective, unregistered analysis of the Inovalon claims database, which covers more than 100 million people, for 2017 through 2022. Patients had continuous insurance enrollment and no nutritional-deficiency diagnosis before starting a GLP-1 drug. Most took liraglutide (78.6%); dulaglutide (10.4%) and semaglutide (9.1%) were the next most common. Mean age was 15 years, 61.5% were female, and 62.6% had obesity.
The design shapes what the numbers can mean. Claims data record only coded diagnoses: a deficiency that is never tested is never counted, so 16.9% is a lower bound that may partly reflect how intensively patients were screened rather than the drugs’ effect. And with no comparison group of similar children not on GLP-1 drugs — obesity itself is associated with low vitamin D — the study cannot establish that the medications raised deficiency risk. The cohort also predates widespread pediatric semaglutide use, limiting its fit to current practice.
One internal comparison needs its own caveat: patients who had nutrition counseling visits showed more recorded deficiencies than those who did not (23.2% vs 14.8%, p<0.01). That pattern is plausibly confounded by indication — patients who develop symptoms are more likely to be referred — rather than evidence about counseling's benefit or harm.
Adult observational data point the same direction: a 2026 narrative review covering 480,825 GLP-1 users reported vitamin D deficiency in 7.5% at six months and 13.6% at 12 months, noting causality is not established.
The full text was not retrievable for this brief, so the funding statement could not be examined; the accessible abstract discloses none. Publisher records show four of six authors hold Abbott Nutrition or Abbott Medical Devices affiliations; independent conflict disclosures could not be examined.
What this means
The supported finding is a care gap: roughly one in six youths in this cohort had a recorded nutritional deficiency within a year, while fewer than one in four had a nutrition counseling visit within six months. The design cannot show whether GLP-1 drugs raise, lower, or leave deficiency risk unchanged — that would require a comparison group. Deficiencies that were never tested for would never appear in claims data. Nothing in this study is a basis for starting or stopping a medication.
Sources
- Kerr KW, Chang AT, Sulo S, Stutts JT, Panchalingam T, Ryder JR. Nutritional Deficiencies, Complications, and Nutrition Therapy/Counseling in Pediatric Patients Using GLP-1 Receptor Agonists. Childhood Obesity. Published online September 17, 2026. https://doi.org/10.1177/21532176261486979 (doi:10.1177/21532176261486979; PMID: 42751742). Abstract-level access; full text blocked (publisher bot wall).
- Context (adult observational data): Urbina J, Salinas-Ruiz LE, Valenciano C, Clapp B. Micronutrient and Nutritional Deficiencies Associated With GLP-1 Receptor Agonist Therapy: A Narrative Review. Clinical Obesity. 2026;16(1):e70070. doi:10.1111/cob.70070. PMID: 41549912. https://pubmed.ncbi.nlm.nih.gov/41549912/
- Press coverage: Ann & Robert H. Lurie Children’s Hospital of Chicago release via ScienceDaily, September 23, 2026. https://www.sciencedaily.com/releases/2026/09/260923035926.htm — used only to corroborate coverage; the release’s “5% received counseling within 30 days” figure is NOT verified in the accessible abstract and is not used in this brief.
