A surprising and historically rare condition – scurvy – is appearing in patients taking GLP-1 receptor agonists, a class of medications including Ozempic, Wegovy, and Mounjaro, primarily used for weight loss and diabetes management. The resurgence of this disease, once commonly known as the “sailors’ disease,” is raising concerns among dietitians and medical professionals about the nutritional impact of these increasingly popular drugs.
Appetite Suppression and Nutritional Deficiencies
GLP-1 medications work by suppressing appetite, which can lead to significant weight loss. However, experts are now warning that this appetite suppression can also result in inadequate dietary intake, leading to serious vitamin deficiencies. Scurvy, caused by a deficiency in vitamin C, is just one example of the potential nutritional consequences. “A reduction in body weight does not automatically mean the person is well-nourished or healthy,” explains Professor Clare Collins of the Newcastle School of Health Sciences in New South Wales, Australia, who led a recent systematic review of existing research on GLP-1 drugs. “Nutrition plays a critical role in health and right now it’s largely missing from the evidence.”
The systematic review highlighted a significant gap in research regarding the dietary habits of patients using GLP-1s. Few global trials have adequately assessed what and how much patients are eating while on these medications, leaving a critical blind spot in understanding the potential for malnutrition.
A Disease From the Past
Scurvy was historically a major threat to sailors on long voyages who lacked access to fresh fruits and vegetables, the primary sources of vitamin C. Symptoms include fatigue, weakness, bleeding gums, and skin rashes. If left untreated, scurvy can be fatal. While relatively rare in developed countries like the US, UK, and Australia due to readily available nutrient-rich foods, cases are now being reported in individuals using GLP-1 medications.
The connection between GLP-1s and scurvy came to light with high-profile cases like that of British pop singer Robbie Williams, who publicly disclosed his diagnosis of what he termed a “17th century pirate disease” after using injectable weight loss medication. He also noted a potential link to degrading eyesight. Doctors in Australia are also reporting an increase in scurvy cases among their patients taking these drugs.
The Need for Increased Oversight and Monitoring
The concern isn’t necessarily about the medications themselves, but rather the lack of attention paid to patients’ nutritional intake while using them. The drugs are effective in promoting weight loss and managing diabetes, but they don’t address the fundamental need for a balanced diet. Dietitians are calling for increased oversight and more comprehensive monitoring of patients on GLP-1s to ensure they are receiving adequate nutrition.
The issue extends beyond vitamin C deficiency. While scurvy is the most prominent example currently being reported, the potential for other vitamin and mineral deficiencies exists due to the overall reduction in food intake. The long-term health consequences of these deficiencies are still largely unknown, emphasizing the need for further research.
What This Means for Patients
For individuals currently taking GLP-1 medications, it’s crucial to prioritize a nutrient-dense diet. This doesn’t necessarily mean drastically increasing food volume, but rather focusing on consuming foods packed with vitamins and minerals. Working with a registered dietitian can be particularly helpful in developing a personalized eating plan that meets individual nutritional needs while managing appetite suppression.
Healthcare providers should also be vigilant in screening patients on GLP-1s for signs of nutritional deficiencies. Regular blood tests can help identify deficiencies early on, allowing for timely intervention with vitamin supplementation or dietary adjustments.
The current situation highlights the importance of a holistic approach to weight management and diabetes care. While medications like GLP-1s can be valuable tools, they should be used in conjunction with lifestyle modifications, including a healthy diet and regular exercise, to ensure optimal health outcomes. Simply focusing on weight loss without addressing nutritional needs can lead to unintended and potentially serious consequences.
The Australian Financial Review reported Professor Collins’ concerns, emphasizing that the focus should shift towards ensuring patients are “well-nourished” alongside weight reduction. This requires a more comprehensive understanding of the impact of GLP-1s on dietary habits and a proactive approach to nutritional monitoring and support.
As of , health officials are continuing to investigate the extent of this issue and develop guidelines for managing the nutritional risks associated with GLP-1 medications.
