Weight-loss medications, like Ozempic, Mounjaro, and Wegovy, have been in the news for the last few years, thanks in large part to the speed at which they promote weight loss. These prescription medications have transformed obesity and diabetes care by dramatically reducing appetite, leading to significant body weight loss. However, recent studies have led researchers to warn that the same mechanisms that facilitate weight loss may carry nutritional risks. These risks include the rare but serious possibility of developing scurvy, a disease caused by severe vitamin C deficiency once commonly seen in sailors on long voyages without access to fresh produce.

Scurvy virtually disappeared in developed countries when the role of vitamin C was understood, and abundant fresh fruits and vegetables became widely available. However, recent studies suggest that people using GLP-1 weight-loss therapies without careful nutritional monitoring may inadvertently restrict their diets so significantly that essential nutrients, including vitamin C.

How GLP-1 Drugs Work and Why Nutrition Matters

GLP-1 medications work by mimicking a hormone that the body naturally produces. This hormone is released in response to eating, helping reduce appetite and control blood sugar. This effect is central to their success in weight loss and diabetes management, but it also means people taking them often consume less food overall.

A recent study conducted by a team of researchers in Australia shows that many trials did not track what participants were actually eating, focusing solely on their weight loss progression. Without adequate data on diet quality and food intake, researchers say it’s unclear whether users are getting enough protein, fiber, vitamins, and minerals. Since the body doesn’t naturally produce vitamin C, it must be obtained from foods like citrus fruits, leafy greens, and berries. Prolonged inadequate intake heightens the link between malnutrition risk and weight-loss meds.

One high-profile example is British pop singer Robbie Williams, who publicly revealed that he was diagnosed with scurvy after taking a drug similar to Ozempic and drastically reducing his food intake, describing it as a “17th-century pirate disease.”

What Scurvy Is and How It Develops

Scurvy is a disease caused by a severe lack of vitamin C. Vitamin C plays a pivotal role in collagen synthesis, a structural protein that’s necessary for healthy blood vessels, skin, bones, and wound healing. It also supports iron absorption. Humans cannot produce vitamin C on their own, so it must come from diet, especially from fresh fruits and vegetables.

Without enough vitamin C, the body’s ability to maintain collagen breaks down. Symptoms of developing scurvy can begin with fatigue, irritability, and joint pain. If the deficiency continues, the symptoms worsen. More serious signs of scurvy include bleeding gums, loose teeth, anemia, bruising, skin changes, and wounds that don’t heal properly. Untreated scurvy can be fatal, though it’s completely preventable with adequate nutritional intake.

Not Just Scurvy: Broader Nutritional Risks With GLP-1 Use

While the risk of scurvy is grabbing headlines because of its rarity in modern times, experts warn that it’s not the only issue that GLP-1 medications can cause. Professor Clare Collins, a nutrition researcher, emphasizes that many studies have largely ignored detailed dietary assessment, leaving gaps in understanding how reduced food intake on these medications affects overall nutrient intake. Collins notes that deficiencies in protein, fiber, and other nutrients can arise if there is a lack of GLP-1 nutritional guidance.

For example, iron deficiency can lead to anemia, and vitamin B1 deficiency can cause conditions like beriberi or Wernicke-Korsakoff syndrome, sicknesses that affect the heart and brain, respectively. These conditions are not specific to GLP-1 drugs but highlight how micronutrient shortfalls can emerge when overall nutrition is not prioritized.

Why Diet Quality Is Essential With Appetite Suppression

GLP-1 drugs achieve weight loss primarily by suppressing appetite. Since patients using these medications consume less, it’s crucial that they choose nutrient-dense foods with essential vitamins and minerals.

Dietitians emphasize that weight loss alone doesn’t guarantee health. Rapid or significant reductions in food intake, if not balanced with thoughtful nutrition, can put users at risk of unintended health complications. That’s why many experts advocating for GLP-1 use also recommend integrating professional nutritional guidance and, if necessary, supplementation to prevent deficiencies while still reaching weight-loss goals.

What Patients and Providers Can Do

Experts agree that patients and providers need to work together to create a more holistic approach to GLP-1 weight loss medications. Before starting treatment, discussing dietary habits with a clinician can help ensure meal plans deliver a broad range of nutrients. Monitoring for signs of malnutrition, scheduling regular nutrient panels, and adjusting diet or supplements as needed are practical steps in promoting long-term health during weight-loss therapy.

Clinicians argue that future clinical trials should include detailed information about dietary habits to determine how these medications affect nutritional status over time. This information would empower clinicians to balance the undeniable metabolic benefits of GLP-1 drugs with strategies to protect overall nutrition and wellness.

Weight-loss meds are changing the way that people pursue healthier lifestyles. Understanding how these potential benefits relate to malnutrition risk is a crucial component of using them safely and effectively going forward.

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