GLP-1 Medications Linked to Nutritional Deficiencies in Children and Young People, Study Finds
Key Takeaways:
- Nearly one in six children and young people (16.8%) prescribed GLP-1 medications for weight loss, prediabetes or type 2 diabetes were diagnosed with a nutritional deficiency within the first year of treatment, with vitamin D deficiency the most common (12.4%).
- Only 5% of patients received nutritional counselling within 30 days of starting a GLP-1 medication, and fewer than 25% received it within six months.
- Researchers are calling for proactive nutritional management from the outset of GLP-1 treatment in children, rather than waiting until a deficiency is diagnosed.
Nutritional risks during a critical stage of development
Children and young people prescribed GLP-1 medications for weight loss, prediabetes or type 2 diabetes are at risk of developing nutritional deficiencies, according to new research from scientists at Northwestern University and Ann & Robert H. Lurie Children’s Hospital of Chicago. The study found that nutritional deficiencies were diagnosed in nearly one in six patients (16.8%) within the first year of treatment.
Vitamin D deficiency was the most frequently identified, affecting 12.4% of children within one year of starting GLP-1 treatment.
The findings were recently published in the journal Childhood Obesity, in a study titled “Nutritional Deficiencies, Complications, and Nutrition Therapy/Counseling in Pediatric Patients Using GLP-1 Receptor Agonists.”
Why adolescence matters
The study’s senior author, Justin Ryder, associate professor of surgery and paediatrics at Northwestern University Feinberg School of Medicine and vice chair of research for the department of surgery at Lurie Children’s, emphasised the importance of understanding these risks as GLP-1 use in younger patients grows.
“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 Ryder. “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.”
A significant gap in nutritional support
Despite these risks, the research revealed that very few children received nutritional support after beginning treatment.
“Nutritional support needs to play a critical role once treatment with a GLP-1 medication is initiated,” he said. “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.”
The gap highlights the need for healthcare professionals working with children and young people living with obesity to consider nutrition as an integral part of care from the moment treatment begins. Clinicians looking to strengthen their understanding in this area may find structured training, such as The College of Contemporary Health’s Childhood Obesity Essentials course, a valuable way to build confidence in supporting this patient group.
How the study was conducted
The researchers analysed national administrative claims data from 2017 to 2022, covering more than 100 million patients. From this dataset, they identified 2,031 young people aged 10–17 years who were using GLP-1 medications, met continuous enrolment criteria and had no prior diagnosis of a nutritional deficiency.
Within this sample, the most commonly prescribed GLP-1 medications were:
- Liraglutide (78.6%)
- Dulaglutide (10.4%)
- Semaglutide (9.1%)
A call for proactive nutritional management
The research team hopes the findings will encourage a shift towards preventive nutritional care for children and young people receiving GLP-1 treatment.
“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,” Ryder said. “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.”
Funding for the study was provided by Abbott.
CCH insight
As GLP-1 medications become more widely used in younger patients, healthcare professionals need the knowledge and skills to support children and young people living with obesity safely and holistically, including their nutritional needs during growth and development. Our Childhood Obesity Essentials CPD course is designed to help clinicians deliver confident, evidence-informed care for this patient group.
Explore Childhood Obesity Essentials and enrol today →
Source: Northwestern University
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Beyond the Scales: New Research Asks Whether GLP-1 Medications Change Daily Life
Key Takeaways:
- A new National Bureau of Economic Research working paper found little evidence that GLP-1 medications produced measurable changes in mental health, self-rated health, employment or marital status among adults living with diabetes.
- Apparent differences between people taking the medications and those who were not largely disappeared once researchers followed the same individuals over time, suggesting the gaps reflected who takes these drugs rather than what the drugs do.
- The findings do not call the clinical value of GLP-1 medications into question: improved glycaemic control, weight loss and better physical health remain the clearest measurable benefits.
A familiar class of medicines, a less familiar question
GLP-1 medications such as Ozempic have reshaped the treatment of Type 2 diabetes. For many people, they help bring blood sugar under control, lower cardiovascular risk and produce substantial weight loss. Those outcomes are now supported by a large and growing body of clinical evidence, and they have made this class of medicines one of the most closely watched developments in contemporary healthcare.
What remains far less certain is whether those physical health improvements ripple outwards into the rest of a person’s life. Do they translate into better mental health? More stable employment? Stronger or more enduring relationships? Researchers are only beginning to test those assumptions, and the answers matter well beyond the consulting room.
What the researchers set out to examine
A new National Bureau of Economic Research working paper takes up precisely that question. The study was conducted by Robert Kaestner, an economist and research professor at the University of Chicago Harris School of Public Policy, alongside co-author Cuiping Schiman.
Among adults with diabetes, the researchers found little evidence that using GLP-1 medications produced measurable changes in mental health, self-rated health, employment or marital status.
“We know these drugs improve health outcomes, and there’s been a great deal of research documenting those benefits,” said Kaestner, a research professor. “What hadn’t really been examined was whether those improvements extended into other parts of people’s lives.”
Why the question matters for coverage decisions
The issue is becoming increasingly important as insurers and government programmes weigh up whether to broaden access to GLP-1 medications. The medical case is already well documented. What is far less clear is whether these treatments also generate social or economic gains that might strengthen the argument for wider coverage.
That distinction is not merely academic. If GLP-1 medications were shown to help people return to work, sustain relationships or experience meaningful improvements in psychological wellbeing, the calculation around funding and eligibility would look rather different. If they do not, decisions will continue to rest primarily on the clinical evidence.
How the study was designed
To investigate, Kaestner and Schiman drew on more than ten years of data from the Medical Expenditure Panel Survey, a nationally representative survey. Their analysis focused on adults with diabetes between 2012 and 2023.
Crucially, the researchers did not rely solely on comparing people who used GLP-1 medications with those who did not. Instead, they followed the same individuals over time. This within-person approach allowed them to observe whether a person’s circumstances actually changed after starting treatment, rather than simply noting how two different groups of people happened to differ.
The team examined several indicators of wellbeing, including symptoms of depression, psychological distress, self-rated health, employment and marital status.
At first glance, people taking GLP-1 medications did appear to differ from those who were not, particularly in relation to employment and marriage. Those differences, however, mostly disappeared once the researchers tracked changes within the same individuals over time.
That pattern points to an important interpretive lesson. The original gaps may well have reflected differences between the kinds of people who take GLP-1 medications and those who do not, rather than any effect caused by the medications themselves. It is a distinction that is easy to lose in headline findings, and one that clinicians are increasingly being asked to explain to the people in their care.
Few measurable changes outside physical health
The results held steady across different time horizons. Whether the researchers looked at people after roughly one year of GLP-1 use or followed them across a longer two-year period, the picture was much the same. In both cases, they found little evidence that taking the medications led to meaningful changes in the broader life outcomes they measured.
Kaestner was careful to stress that this is not the same as proving GLP-1 medications have no effects beyond physical health. Some changes may simply be more subtle, or harder to capture with the measures available.
“We measured outcomes like whether someone became employed or unemployed, whether they got married or divorced, and standard indicators of mental health,” he said. “Those are important measures, but they don’t necessarily capture changes in self-esteem, relationship quality, or other day-to-day experiences.”
In other words, the study was well placed to detect large, discrete shifts in a person’s circumstances. It was less able to register the quieter changes that people themselves often describe as the most significant: feeling more confident, moving through the world with greater ease, or relating differently to food and to other people.
The medical benefits remain well established
The researchers were equally clear that their findings do not undermine the medical value of GLP-1 medications. For adults with diabetes, Kaestner noted, the clearest measurable benefits remain those already demonstrated in clinical research, including improved glycaemic control, weight loss and better physical health.
This is the balance clinicians are increasingly asked to strike in practice: conveying genuine confidence in the clinical evidence while setting realistic expectations about what a medication can and cannot be expected to change. Practitioners looking to strengthen that footing often turn to structured CPD, such as the College of Contemporary Health’s GLP-1RAs in Focus short course, which examines the evidence base underpinning this class of medicines and how it translates into everyday clinical conversations.
A young and expanding field of research
As GLP-1 medications are prescribed more widely beyond diabetes, and become increasingly common in weight management, researchers will have far more opportunity to test whether broader social effects emerge in other populations or over longer follow-up periods.
“This is still a very new area of research,” he said. “As use continues to grow, understanding these broader consequences will become increasingly important for patients, clinicians, and policymakers alike.”
For now, the evidence suggests a more measured conclusion than the surrounding public conversation often implies. GLP-1 medications can meaningfully change a person’s physical health. Whether, and how, they change a person’s life is a question the research is only starting to ask.
CCH insight
Supporting people prescribed GLP-1 receptor agonists calls for a clear grasp of the evidence, including its limits. GLP-1RAs in Focus, a CPD-accredited short course from the College of Contemporary Health, is designed for healthcare professionals who want a confident, evidence-informed foundation in this rapidly developing area.
Source: University of Chicago Harris School of Public Policy
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Weight Bias at Work: What New GLP-1 Research Reveals About Women’s Employment Prospects
Key Takeaways:
- Women who were unemployed when they started GLP-1 medications saw their employment rate rise by nearly 27 percentage points over 18 months, according to a 2026 NBER working paper.
- The gains appeared only among women entering the workforce – those already employed saw no rise in pay or promotion, pointing to perception rather than capability.
- The findings echo long-standing evidence on the financial cost of weight bias, from documented pay gaps to hiring professionals’ judgements based on photographs alone.
A new way to measure an old problem
For years, economists have documented what they call the “obesity penalty” – the social and financial disadvantages people can face because of their weight. It has been a difficult phenomenon to measure cleanly, because the factors that shape someone’s body weight also tend to shape their income, health and opportunities.
The rapid uptake of GLP-1 medications has given researchers something closer to a natural experiment. When large numbers of people begin treatment within a short window, and others who want the same treatment have not yet been able to start, it becomes possible to compare two otherwise similar groups and observe what changes.
That is the approach taken in a 2026 working paper published by the National Bureau of Economic Research, in which Harvard economist Rebecca Diamond examined what happened to women’s employment after they began taking GLP-1 medications.
What the researchers did
Diamond looked at survey data from around 15,000 people. She compared women who had started taking GLP-1 medications with similar women who wanted to take them but had not yet started. The two groups were matched on factors including income, race, body mass index and overall health, so that the comparison was not simply between people in very different circumstances to begin with.
The design matters. Because the comparison group consisted of women who also wanted the medications, the study is less vulnerable to the criticism that people who seek treatment are systematically different in motivation from those who do not.
The result that stands out
Among women who were unemployed at the point they began treatment, the employment rate rose by nearly 27 percentage points over the following 18 months, compared with the matched group who had not yet started.
To put that figure in context, it is a larger gap than the difference in employment between American women with a high school diploma and those holding a university degree. In other words, an 18-month change in body weight was associated with a bigger shift in employment than several years of formal education.
The research does not suggest that losing weight made these women more intelligent, more capable or better qualified for work. Nothing about their skills, experience or credentials changed. What the study raises is a different and more uncomfortable question: whether a change in appearance alters how women are perceived by employers.
Changes beyond the workplace
The effects were not confined to employment. The study also found that single women taking GLP-1 medications were nearly 29 percentage points more likely to get married or move in with a partner than similar women who had not started treatment.
Taken together, the employment and partnership findings describe something broader than a labour market effect. They describe a shift in social response.
The financial cost of weight bias
GLP-1 medications have moved quickly into the mainstream. In 2026, 11% of US adults said they were currently taking one to lose weight, up from just 3% in 2024, according to Gallup.
But the question of how weight shapes women’s working lives long predates the current wave of prescribing. Research was already pointing in this direction well before GLP-1 medications entered the cultural conversation.
What hiring professionals saw
A report from Fairygodboss, an employer review site for women, offered a particularly troubling look at how appearance can shape hiring decisions. In one study, hiring professionals were shown images of women with different body types and asked to evaluate them.
The woman pictured at the highest body weight was judged far more harshly than the others. Twenty percent of respondents described her as “lazy”, a label applied less frequently to every other woman pictured. Just 18% said she appeared to have leadership potential, while 21% described her as “unprofessional”.
These are judgements made on the basis of a photograph alone, with no information about experience, qualifications or performance.
Earnings gaps documented long before GLP-1 medications arrived
The pay data tells a similar story. In 2011, the Federal Reserve Bank of St Louis cited research finding that white women living with overweight earned about 4.5% less than white women whose BMI fell within what researchers classified as the normal range. White women living with obesity earned nearly 12% less.
Two caveats are important here. Those figures were specific to white women and do not apply to everyone. They also say nothing about anyone’s value, ability or contribution. What they suggest is that weight-related bias was already showing up in some women’s pay long before GLP-1 medications became widely available.
When appearance pays
The argument that appearance carries an economic premium is not new, and it is sometimes made bluntly. Codie Sanchez, CEO and founder of Contrarian Thinking, has said that women who wear makeup to work earn about 30% more on average than women who do not.
“Pretty privilege is very real,” she said on an episode of The Burnouts Podcast. “And you can either say ‘That’s not fair, so I’m not doing it.’ or you can win.”
Sanchez acknowledged that the advantage is unfair, but argued that women should use it rather than ignore it. “If it’s going to make me more money to paint my face, clown me up,” she said.
Diamond’s findings suggest weight bias may operate along similar lines. The women who benefited most were those seeking to enter the workforce, where first impressions carry disproportionate weight and where an employer’s judgement is formed quickly and on limited information. For women already in a job, whose managers had direct evidence of their performance, the effect disappeared.
Why this matters in clinical practice
For healthcare professionals, findings like these complicate the consultation room. People starting GLP-1 medications may be motivated by clinical goals, social goals, economic goals, or some mixture of all three, and those motivations shape expectations, adherence and how someone responds if treatment is paused or stopped.
Understanding the pharmacology well enough to have that conversation credibly is increasingly part of everyday practice rather than a specialist concern. Building that grounding is the focus of professional training such as the College of Contemporary Health’s GLP-1RAs in Focus – Why Drugs Like Ozempic Work, a CPD-accredited online short course covering GLP-1 physiology and pharmacology for prescribers and non-prescribers alike.
An uncomfortable conclusion
Losing weight does not make a person more intelligent, more capable, harder working or better qualified for a job. But it may change how other people perceive them.
That is precisely what makes Diamond’s findings difficult to sit with. If some women gain access to more opportunities after losing weight while their underlying abilities remain exactly the same, then the economic benefit is not really a benefit at all. It is a measure of how heavily appearance still shapes the way women are perceived and treated – and of how much value has been withheld from them beforehand.
The medication changed the response. It did not change the woman.
CCH insight
Findings like these are a reminder that GLP-1 medications carry social and economic weight as well as clinical effect – and that patients arrive at the consultation with motivations shaped by far more than a treatment target. CCH’s GLP-1RAs in Focus – Why Drugs Like Ozempic Work CPD short course (2 CPD hours, fully online, CPD-accredited) builds the foundation in GLP-1 physiology and pharmacology that healthcare professionals need to explain the science clearly, set realistic expectations and contribute confidently to treatment discussions, whether or not they prescribe.
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People with Obesity Tend to Move Less After Starting GLP-1 Medications, Study Finds
Key Takeaways:
- Daily step counts and moderate-to-vigorous activity both dropped after adults with obesity started a GLP-1 receptor agonist, with no sign that weight loss prompted people to move more.
- Because these medications strip away lean muscle as well as fat, staying active matters for protecting strength and long-term health rather than being an optional extra.
- This is the first large study to draw on data from wearable fitness trackers in adults taking GLP-1 medications, and its authors argue for targeted support that builds activity in alongside treatment.
A counterintuitive picture of how people move
It is tempting to assume that as the weight comes off, people naturally become more active. New findings suggest the opposite may be closer to the truth. Adults with obesity who were losing weight on glucagon-like peptide-1 (GLP-1) receptor agonist medications significantly reduced their physical activity, according to a study being presented on Saturday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, Illinois.
That matters because activity is one of the main safeguards against an unwanted side effect of these treatments. GLP-1 receptor agonists such as semaglutide, liraglutide, dulaglutide and tirzepatide reduce not only fat but also lean muscle mass. This makes physical activity essential for preserving strength and long-term health, according to study lead Sajana Maharjan, M.D., of HSHS St. John’s Hospital in Springfield, Illinois.
How the study was carried out
The work was a retrospective pre–post cohort study, meaning researchers compared the same individuals before and after they started treatment. It drew on data from the National Institutes of Health’s All of Us Research Program, which links participants’ electronic health records with their Fitbit activity data, allowing the team to track real-world movement rather than relying on self-reported habits.
Among the 1,950 adults with obesity who started a GLP-1 medication, researchers studied 753 people who had enough wearable-device data for analysis. The cohort was predominantly female, at 78.6 per cent, with a mean age of 52.7 years.
For each person, the researchers compared physical activity before and after treatment began, focusing on two measures: daily step counts and minutes of moderate-to-vigorous physical activity (MVPA).
Steps and active minutes both fell
The direction of travel was clear. On average, daily steps decreased from 5,047 to 4,487 per day, while MVPA minutes fell from 28 to 22 per day after people began a GLP-1 receptor agonist medication.
Crucially, the study found no evidence that weight loss from these medications led to increased physical activity. The expected rebound in movement simply did not appear in the data.
Who saw the biggest changes
The decline was not evenly spread. The largest drops were seen in men and in people living with joint or muscle pain. By contrast, factors such as age, heart failure or a prior stroke did not change the results, suggesting the pattern held across a fairly broad range of circumstances.
Why activity cannot be an afterthought
For Dr Maharjan, the practical message is that exercise needs to be designed into treatment rather than left to chance:
“While many assume that weight loss leads naturally to increased physical activity, our study suggests otherwise. The findings in our study reinforce that exercise cannot be optional for people taking these medications. People need targeted interventions that encourage physical activity alongside medication for obesity.”
Given that GLP-1 receptor agonists reduce lean muscle alongside fat, a fall in activity could compound the loss of strength, making structured support for movement an important part of care rather than a nice-to-have.
A first for wearable-data research
The study stands out for its method as much as its findings. It is the first large study analysing data from wearable fitness trackers among adults taking GLP-1 receptor agonists, offering a more objective window into everyday behaviour than questionnaires alone can provide. As these medications become more widely used, that kind of real-world evidence is likely to shape how clinicians and patients approach physical activity during treatment.
CCH insights:
This is a very interesting study, but it throws up more questions than answers. Firstly, were any of the participants receiving diet and lifestyle advice as they are supposed to? GLP-1 medications are designed as an adjunct to such advice, but these results suggest it was probably lacking from these patients’ treatment. Another question, of course, is why did physical activity drop? Further research is needed to understand what is the underlying reason for these results. But most importantly, this study is a reminder that GLP-1 therapy is not just about taking the medication, it requires diet and lifestyle advice and ongoing support and monitoring.
Source: Endocrine Society
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