GLP-1 Receptor Agonists - Good for Body Weight, Bad for Micronutrient Status?

GLP-1受体激动剂——对体重有益,但对微量营养素水平有害?

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Abstract

Obesity is a global health issue with a prevalence predicted to affect 24% of the world's population by 2035. A high-caloric intake and a sedentary lifestyle are, along with other factors, the main causes of obesity. Since 2014, the pharmacological use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which mimic the gut hormone GLP-1, has provided an alternative to lifestyle interventions for tackling obesity. GLP-1 RAs suppress appetite and slow gastrointestinal transit time. This reduces food and energy intake to a degree that previous pharmacotherapies have not achieved. Mechanistically, GLP-1 RAs act through peripheral and central nervous pathways, increasing insulin secretion while inhibiting glucagon release and gastric motility. The significant reduction in food consumption raises concerns about adequate dietary intakes with an increased risk of micronutrient deficiencies, particularly among obese individuals. Here, we highlight the need for further research by summarizing current evidence on GLP-1 RA and its potential impact on dietary patterns and micronutrient status. Relevant publications were identified through searches in PubMed/Medline, Scopus, Cochrane Databases, Google Scholar, Web of Science, and Embase databases up to June 2025. Only peer-reviewed articles published in English were considered. We found that the clinical use of GLP-1 RA reduces energy intake by ≤40%, resulting in notable weight loss compared with traditional lifestyle modifications. Consequently, professional dietary counseling is essential in order to support the selection and consumption of nutrient-dense, protein-rich foods and prevent nutrient inadequacies and loss of muscle mass during weight loss. However, given its widespread use in the general population, many individuals using GLP-1 RA may not be under supervision. This could markedly increase risk of micronutrient deficiencies, which are already more prevalent in obesity. Future research is needed to systematically investigate the long-term nutritional consequences of GLP-1 RA, paying particular attention to micronutrient intake and status.

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