Nutritional Deficiencies, Complications, and Nutrition Therapy/Counseling in Pediatric Patients Using GLP-1 Receptor Agonists

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used to treat childhood obesity, prediabetes, and type 2 diabetes. We examined nutritional deficiency incidence and nutrition therapy/counseling (NT/C) utilization among pediatric GLP-1RA users. Methods: We analyzed Inovalon administrative claims data from 2017 to 2022 covering over 100 million patients to identify 2,031 GLP-1RA users aged 10–17 years who met continuous enrollment criteria and had no prior diagnosis of nutritional deficiency. Nutritional deficiencies were identified using the International Classification of Diseases, 10th edition codes for up to 1 year following GLP-1RA initiation. NT/C visits, time to first NT/C visit, and differences in nutritional deficiency diagnoses by NT/C consultation were assessed. Results are reported as proportions and means, with group comparisons using chi-square tests. Results: The mean age was 15 (±1.8) years, 61.5% were female, and 62.6% had obesity. Liraglutide (78.6%), dulaglutide (10.4%), and semaglutide (9.1%) were the most prescribed GLP-1RA drugs. Within 1 year, 16.88% of patients were diagnosed with at least one nutritional deficiency or deficiency-related complication, most frequently vitamin D deficiency (12.4%), followed by nutritional anemia (1.55%), and iron-deficiency anemia (1.44%). Only 23.3% had NT/C visit within 180 days (mean time to first visit: 149 days). Patients with NT/C consultations had higher rates of nutritional deficiencies and deficiency-related complications than those without (23.2% vs. 14.8%, p < 0.01). Conclusions: Nutritional deficiencies are a meaningful and under-recognized risk among pediatric patients receiving GLP-1RA therapy. Current care patterns suggest missed opportunities for proactive and preventative nutrition support. Integration of NT/C care into pediatric GLP-1RA treatment may support healthy growth and long-term outcomes.