A growing body of evidence suggests a potential, and somewhat surprising, side effect of the increasingly popular GLP-1 weight-loss medications like Ozempic, Wegovy, and Mounjaro: nutrient deficiencies, including a condition historically known as scurvy. While these drugs are highly effective in promoting weight loss, experts are raising concerns that the significant reduction in appetite they induce may lead individuals to consume inadequate amounts of essential vitamins and minerals.
Scurvy, famously associated with long sea voyages where sailors lacked access to fresh fruits and vegetables, is caused by a severe deficiency in vitamin C. Symptoms, if left untreated, can be debilitating, ranging from anemia and loose teeth to bruising, bleeding gums, and impaired wound healing. In , British pop singer Robbie Williams was diagnosed with scurvy after taking a medication “something like Ozempic,” according to reports in The Mirror.
The concern isn’t that these medications directly *cause* scurvy, but rather that they indirectly increase the risk by suppressing appetite and reducing overall food intake. “A reduction in body weight does not automatically mean the person is well-nourished or healthy,” explains Clare Collins, laureate professor of nutrition and dietetics at The University of Newcastle, Australia. “Nutrition plays a critical role in health, and right now it’s largely missing from the evidence.”
A systematic review by the Hunter Medical Research Institute in Australia highlighted a critical gap in clinical trials for these medications: a failure to adequately assess and report on the dietary habits of participants. Researchers found that while GLP-1 drugs demonstrably support weight loss, there’s limited understanding of *what* people are actually eating while taking them. This lack of dietary monitoring is a key concern, as it obscures the potential for nutrient deficiencies.
The mechanism is straightforward. These medications, which mimic the effects of a natural hormone called GLP-1, reduce appetite, increase feelings of fullness, and curb cravings. While effective for weight management, this can lead to a significant decrease in calorie intake – ranging from 16-39% according to recent research – and, crucially, a reduction in the consumption of nutrient-rich foods.
It’s not just vitamin C deficiency that’s a worry. Experts emphasize that a range of nutrient deficiencies are possible. Iron deficiency, leading to anemia, and vitamin B1 deficiency, which can cause neurological and cardiac problems, are also potential risks. “There are other nutrients that, if not consumed in adequate amounts, can lead to deficiencies,” Collins notes.
The challenge in identifying these deficiencies lies in the overlap between early symptoms of nutrient deficiencies and common side effects of the medications themselves. Fatigue, lethargy, nausea, and irritability can all be attributed to either the drug or a lack of essential nutrients, making diagnosis difficult. “The signs can be missed because they overlap initially with side effects of the medications,” Collins explains.
Philip Rabito, an endocrinologist and weight-loss specialist in New York City, confirms that protein-calorie malnutrition and micronutrient deficiencies are potential consequences of using GLP-1 medications without careful dietary management. He suggests that all patients starting these medications should be screened for pre-existing deficiencies and receive guidance on maintaining a balanced, nutrient-dense diet.
The issue is further compounded by behavioral factors. Ilana Muhlstein, a registered dietitian nutritionist, points out that many clinical trials haven’t even bothered to track what patients are eating, focusing solely on weight loss. She observes that some individuals view the medications as “permission to starve themselves,” neglecting the importance of dietary quality.
So, what can be done? Experts recommend a multi-faceted approach. Individuals taking GLP-1 medications should work with a registered dietitian to develop a personalized eating plan that prioritizes nutrient-rich foods. This includes consuming at least two cups of vegetables daily, ensuring adequate protein intake at each meal, and incorporating complex carbohydrates and healthy fats.
For those experiencing significant appetite suppression, nutritional supplementation may be necessary. Protein powder, fiber supplements, omega-3 fatty acids, and a comprehensive multivitamin with minerals can help bridge the nutritional gap. Regular monitoring of vitamin and mineral levels through blood tests is also crucial, allowing healthcare providers to identify and address any deficiencies promptly.
Rabito emphasizes the importance of proactive screening for deficiencies *before* starting treatment and ongoing monitoring throughout therapy. He advocates for clinicians to emphasize adherence to a balanced diet with defined protein targets to preserve lean body mass and prevent frailty.
the key to safely and effectively utilizing these powerful weight-loss medications lies in recognizing that they are a tool, not a cure-all. As Muhlstein puts it, they can be viewed as “training wheels,” providing support while individuals work on establishing sustainable, healthy eating habits. A holistic approach that combines medication with comprehensive nutritional guidance is essential to minimize risks and maximize long-term health benefits.
