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Cited by 18Pharmacology and Obesity TreatmentRegulation of Appetite and ObesityDiabetes Treatment and Management

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

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Kerlikowsky, Felix, Krämer, Klaus, Eggersdorfer, Manfred, Hahn, Andreas·2025·Current Developments in Nutrition
DOI 10.1016/j.cdnut.2025.107587PMC PMC12664951
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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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  • The third theoretical dimension is nutritional: reduced caloric intake under GLP-1 therapy can coexist with micronutrient deficiencies that berberine might accentuate through transporter modulation.

    “The third is nutritional: reduced caloric intake under GLP-1 therapy can coexist with micronutrient deficiencies [121,122] that berberine might accentuate through transporter modulation [65,121].”

    From Berberine-Drug Interactions: Mechanisms, Clinical Relevance and Risk Stratification-A Narrative Review (2026) · cites this paper as [122]

    The Abstract reports reduced energy intake during GLP-1 therapy and raises concern about micronutrient deficiencies. The Consequences section says the evidence is insufficient to determine whether deficiency risk increases. Neither that section nor the passages retrieved by searching for berberine and transporter modulation supports the proposed berberine mechanism. (LLM, conf=0.88)

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References 40 · Cited by 18

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  1. [1]Blüher M. Obesity: global epidemiology and pathogenesis Nat. Rev. Endocrinol. 15 5 2019 288 298 30814686
  2. [2]Hauner H. Lautenbach A. Blüher M. Umsetzung der leitliniengerechten Basistherapie der Adipositas in Deutschland Deutsche medizinische Wochenschrift 150 12 2025 668 674 40388976
  3. [3]Wing R.R. Hill J.O. Successful weight loss maintenance Annu. Rev. Nutr. 21 2001 323 341 11375440
  4. [4]Adams T.D. Gress R.E. Smith S.C. Halverson R.C. Simper S.C. Rosamond W.D. Long-term mortality after gastric bypass surgery N. Engl. J. Med. 357 8 2007 753 761 17715409
  5. [5]Müller T.D. Blüher M. Tschöp M.H. DiMarchi R.D. Anti-obesity drug discovery: advances and challenges Nat. Rev. Drug Discov. 21 3 2022 201 223 34815532 PMC8609996
  6. [7]Smith S.R. Weissman N.J. Anderson C.M. Sanchez M. Chuang E. Stubbe S. Multicenter, placebo-controlled trial of lorcaserin for weight management N. Engl. J. Med. 363 3 2010 245 256 20647200
  7. [11]Holst J.J. The physiology of glucagon-like peptide 1 Physiol. Rev. 87 4 2007 1409 1439 17928588
  8. [13]van Bloemendaal L. Veltman D.J. ten Kulve J.S. Groot P.F.C. Ruhé H.G. Barkhof F. Brain reward-system activation in response to anticipation and consumption of palatable food is altered by glucagon-like peptide-1 receptor activation in humans Diabetes Obes. Metab. 17 9 2015 878 886 26094857
  9. [14]Drucker D.J. Mechanisms of action and therapeutic application of glucagon-like peptide-1 Cell Metab. 27 4 2018 740 756 29617641
  10. [15]Jalleh R.J. Rayner C.K. Hausken T. Jones K.L. Camilleri M. Horowitz M. Gastrointestinal effects of GLP-1 receptor agonists: mechanisms, management, and future directions Lancet. Gastroenterol. Hepatol. 9 10 2024 957 964 39096914
  11. [18]Wilding J.P.H. Batterham R.L. Calanna S. Davies M. van Gaal L.F. Lingvay I. Once-weekly semaglutide in adults with overweight or obesity N. Engl. J. Med. 384 11 2021 989 1002 33567185
  12. [19]Apostolopoulou M. Koufakis T. Predicting treatment response to GLP-1 receptor agonists: still tossing the coin or doing better? Expert Opin. Pharmacother. 26 10 2025 1113 1115 40476563
  13. [20]Pellegrini M. Rahimi F. Boschetti S. Devecchi A. de Francesco A. Mancino M.V. Pre-operative micronutrient deficiencies in patients with severe obesity candidates for bariatric surgery J. Endocrinol. Invest. 44 7 2021 1413 1423 33026590 PMC8195915
  14. [21]Ryan D.H. Lingvay I. Deanfield J. Kahn S.E. Barros E. Burguera B. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial Nat. Med. 30 7 2024 2049 2057 38740993 PMC11271387
  15. [22]Garvey W.T. Batterham R.L. Bhatta M. Buscemi S. Christensen L.N. Frias J.P. Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial Nat. Med. 28 10 2022 2083 2091 36216945 PMC9556320
  16. [26]Zhang W. Chen P. Huo S. Huang X. Zhao Y. Requirements for essential micronutrients during caloric restriction and fasting Front. Nutr. 11 2024 1363181 PMC10936542 38481969
  17. [27]Gardner C.D. Kim S. Bersamin A. Dopler-Nelson M. Otten J. Oelrich B. Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A to Z study AJCN 92 2 2010 304 312 PMC2904033 20573800
  18. [28]Hart T.L. Petersen K.S. Kris-Etherton P.M. Nutrition recommendations for a healthy pregnancy and lactation in women with overweight and obesity - strategies for weight loss before and after pregnancy Fertil. Steril. 118 3 2022 434 446 36050124
  19. [29]Stein J. Stier C. Raab H. Weiner R. Review article: the nutritional and pharmacological consequences of obesity surgery, Aliment Pharmacol. Ther. 40 6 2014 582 609 25078533
  20. [30]Chiang E.-P. Smith D.E. Selhub J. Dallal G. Wang Y.-C. Roubenoff R. Inflammation causes tissue-specific depletion of vitamin B6 Arthritis Res. Ther. 7 6 2005 R1254 1262 16277678 PMC1297572
  21. [32]Damms-Machado A. Weser G. Bischoff S.C. Micronutrient deficiency in obese subjects undergoing low calorie diet Nutr. J. 11 2012 34 22657586 PMC3404899
  22. [33]Christensen S. Robinson K. Thomas S. Williams D.R. Dietary intake by patients taking GLP-1 and dual GIP/GLP-1 receptor agonists: a narrative review and discussion of research needs Obes. Pillars 11 2024 100121 PMC11340591 39175746
  23. [34]Santos I. Sniehotta F.F. Marques M.M. Carraça E.V. Teixeira P.J. Prevalence of personal weight control attempts in adults: a systematic review and meta-analysis Obesity Rev 18 1 2017 32 50 PMC5215364 27653242
  24. [37]Poli V.F.S. Sanches R.B. Moraes A.D.S. Fidalgo J.P.N. Nascimento M.A. Bresciani P. The excessive caloric intake and micronutrient deficiencies related to obesity after a long-term interdisciplinary therapy Nutrition 38 2017 113 119 28526376
  25. [38]Tarracchini C. Lugli G.A. Mancabelli L. van Sinderen D. Turroni F. Ventura M. Exploring the vitamin biosynthesis landscape of the human gut microbiota mSystems 9 10 2024 e00929-24 PMC11494892 39287373
  26. [40]Heise T. DeVries J.H. Urva S. Li J. Pratt E.J. Thomas M.K. Tirzepatide reduces appetite, energy intake, and fat mass in people with type 2 diabetes Diabetes Care 46 5 2023 998 1004 36857477 PMC10154650
  27. [43]Blundell J. Finlayson G. Axelsen M. Flint A. Gibbons C. Kvist T. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity Diabetes Obes. Metab. 19 9 2017 1242 1251 28266779 PMC5573908
  28. [45]Richards J.R. Khalsa S.S. Highway to the danger zone? A cautionary account that GLP-1 receptor agonists may be too effective for unmonitored weight loss Obes. Rev. 25 5 2024 e13709 PMC11144546 38320760
  29. [46]He L. Li Q. Yang Y. Li J. Luo W. Huang Y. Pharmacovigilance study of GLP-1 receptor agonists for metabolic and nutritional adverse events Front. Pharmacol. 15 2024 1416985 PMC11260617 39040467

Authors
Kerlikowsky, F., Krämer, K., Eggersdorfer, M., & Hahn, A.
Affiliations
  • Leibniz University Hannover (DE)
  • Johns Hopkins University (US)
  • University Medical Center Groningen (NL)
Corresponding author
Hahn, Andreas
ORCID
Venue
Current Developments in Nutrition
Publisher
Elsevier BV
Published
2025-11
Volume
9
Issue
11
Pages
107587
ISSN
2475-2991 (ISSN-L)
DOI
10.1016/j.cdnut.2025.107587
PMC
PMC12664951
OpenAlex
W4415711965
Cited by
18
References
40
Citations by year
2026: 18
FWCI
10.18
Type
journal article
Language
en
Open access
Licence
Locations
  • Current Developments in Nutrition (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Institutional Repository of Leibniz Universität Hannover (Leibniz Universität Hannover) (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
  • Leibniz Universität Hannover (cc-by)
Topics
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
GLP-1 receptor agonists, obesity, micronutrient status, micronutrient deficiency, weight loss, appetite suppression, dietary intake, energy intake reduction, nutrition counseling, muscle mass loss, high-protein diet, gastrointestinal hormones

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