People newly starting GLP-1 receptor agonist medications show significant nutritional gaps, with nearly 70% not getting enough folate and 63% falling short on iron during their first year, according to a Gram Research analysis of national health data from 4,374 Americans with type 2 diabetes. However, people who stayed on these medications for longer than a year developed eating patterns similar to non-users, suggesting the body adjusts over time.
Researchers analyzed eating habits of over 4,000 Americans with type 2 diabetes, comparing those taking GLP-1 receptor agonist medications (like Ozempic and Wegovy) to those who weren’t. According to Gram Research analysis, people newly starting these medications showed nutritional gaps in folate, iron, and B vitamins during their first year, while those on the drugs longer had eating patterns closer to non-users. The findings suggest that people on these popular weight-loss and diabetes drugs may need extra attention to their nutrition, especially when they first start taking them.
Key Statistics
A 2026 analysis of National Health and Nutrition Examination Survey data covering 4,374 Americans with type 2 diabetes found that 69% of people newly starting GLP-1 medications had inadequate folate intake, compared to 49% of non-users.
Among 127 GLP-1 medication users tracked in a 2026 study of 4,374 diabetic Americans, short-term users showed iron inadequacy in 63% of cases versus 27% in non-users, a statistically significant difference.
A 2026 analysis of 4,374 Americans with type 2 diabetes found that people taking GLP-1 medications for less than one year showed nutritional shortfalls in five key nutrients: folate, iron, niacin, potassium, and vitamin B6.
In a 2026 study of 4,374 diabetic Americans, long-term GLP-1 medication users (1+ year) developed food consumption patterns that more closely resembled non-users than short-term users, suggesting dietary adaptation over time.
The Quick Take
- What they studied: How the eating habits and nutrient intake of people taking GLP-1 receptor agonist medications (diabetes and weight-loss drugs) compare to people not taking these medications
- Who participated: 4,374 American adults over age 30 with type 2 diabetes, tracked between 2007 and 2020. The group included 4,247 non-users, 42 people who had taken the medication for less than a year, and 85 people who had taken it for a year or longer
- Key finding: People newly starting GLP-1 medications showed significant nutritional gaps—nearly 70% weren’t getting enough folate, 63% weren’t getting enough iron, and similar shortages appeared for niacin, potassium, and vitamin B6. These gaps were much more common than in people not taking the medication
- What it means for you: If you’re starting a GLP-1 medication, you may need to pay closer attention to eating nutrient-rich foods or consider talking to a doctor about supplements, especially during your first year on the medication. This doesn’t mean the medication is bad—just that your body’s nutritional needs may change
The Research Details
Researchers used data from the National Health and Nutrition Examination Survey (NHANES), a large government program that tracks what Americans eat and their health. They looked at information collected between 2007 and 2020 from people with type 2 diabetes, dividing them into three groups: those not taking GLP-1 medications, those who had recently started (less than 1 year), and those who had been taking them longer (1 year or more).
For each person, researchers recorded everything they ate and drank, then calculated how much of each nutrient they consumed. They compared these numbers across the three groups to see if there were differences. They also used statistical methods to account for other factors that might affect eating habits, like age, weight, and overall health status.
This type of study is called a cross-sectional analysis, which means researchers took a snapshot of people at one point in time rather than following the same people over months or years. This approach is good for spotting patterns but can’t prove that the medication directly caused the dietary changes.
Understanding how medications affect eating habits is important because it helps doctors and patients prepare for potential nutritional gaps. When people take GLP-1 medications, they often feel less hungry and eat smaller portions, which could make it harder to get all the nutrients their body needs. By identifying which nutrients are most likely to be lacking, doctors can give better advice about what to eat or whether supplements might help.
This study used real-world data from a well-respected government health survey, which is a strength. However, the number of people actually taking GLP-1 medications in the study was quite small (only 127 people total), which makes it harder to be confident in the findings. The study also couldn’t prove cause-and-effect—it only showed that people on these medications had different eating patterns. Additionally, the data was collected over many years as these medications became more popular, so earlier data may not reflect how people use them today.
What the Results Show
People who had recently started GLP-1 medications (within the past year) showed the biggest nutritional gaps. Nearly 70% of short-term users weren’t getting enough folate (a B vitamin important for cell health), compared to only 49% of people not taking the medication. For iron, 63% of short-term users had inadequate intake versus 27% of non-users. Similar patterns appeared for niacin (57% vs. 26%), potassium (95% vs. 71%), and vitamin B6 (66% vs. 47%).
Interestingly, people who had been taking GLP-1 medications for a year or longer showed a different pattern. Their eating habits looked much more similar to people not taking the medication, suggesting that over time, people may adjust their diets to meet their nutritional needs better.
When researchers looked at the types of foods people ate, they found that non-users ate more high-carbohydrate foods like rice, while GLP-1 users ate more protein-rich foods like beef. This makes sense because these medications can change how hungry people feel and what foods appeal to them.
The study also found that people newly starting the medication ate slightly less overall (about 200 calories less per day), though this difference wasn’t statistically significant. Long-term users actually ate slightly more than non-users, suggesting their appetite may normalize over time.
When researchers looked only at people who were obese, they found similar patterns of nutritional gaps in short-term GLP-1 users. This suggests the findings aren’t unique to people with diabetes but may apply more broadly to anyone starting these medications. The research also showed that the specific nutrients most likely to be lacking—folate, iron, B vitamins, and potassium—are all important for energy, immune function, and overall health.
This is one of the first large studies to examine the eating patterns of GLP-1 medication users in the general U.S. population. Previous research has focused mainly on weight loss and blood sugar control, not on whether people are getting all the nutrients they need. The findings align with what doctors have observed in practice: people on these medications sometimes need nutritional guidance to avoid deficiencies.
The biggest limitation is that very few people in the study were actually taking GLP-1 medications (only 127 out of 4,374), which makes the results less reliable. The study also couldn’t prove that the medication caused the dietary changes—people might have changed their eating habits for other reasons. Additionally, the data was collected over 13 years as these medications became more popular, so the eating patterns of early users might differ from today’s users. Finally, the study relied on people remembering what they ate, which isn’t always accurate.
The Bottom Line
If you’re starting a GLP-1 medication, talk to your doctor or a registered dietitian about your nutrition. Focus on eating nutrient-dense foods like leafy greens (for folate), lean meats and beans (for iron and protein), and whole grains (for B vitamins). You might benefit from a multivitamin during your first year on the medication, but ask your doctor first. Moderate confidence: These recommendations are based on observed patterns, not on a controlled trial proving supplements help.
Anyone starting a GLP-1 medication for diabetes or weight loss should pay attention to these findings. People with a history of nutritional deficiencies, vegetarians or vegans (who may already struggle with iron and B12), and older adults should be especially careful. If you’re not taking a GLP-1 medication, these findings don’t directly apply to you, though the general advice to eat nutrient-rich foods is always good.
Nutritional gaps appear to develop within the first few months of starting the medication, based on the study’s findings. The good news is that people who stay on the medication for a year or longer seem to adjust their eating patterns naturally. However, you shouldn’t wait a year to address potential deficiencies—talk to your doctor early if you’re concerned.
Frequently Asked Questions
Do GLP-1 medications like Ozempic cause nutritional deficiencies?
People newly starting GLP-1 medications show nutritional gaps in folate, iron, and B vitamins during their first year, likely because they eat less overall. The medication itself doesn’t cause deficiencies, but reduced appetite may make it harder to get all needed nutrients without planning.
Should I take vitamins if I’m on a GLP-1 medication?
Talk to your doctor before starting supplements. Research shows short-term users have nutritional gaps, so a multivitamin might help, but your specific needs depend on your diet and health. Your doctor can test for deficiencies and recommend what you actually need.
How long does it take to adjust eating habits on GLP-1 medications?
According to research, people on GLP-1 medications for a year or longer develop eating patterns similar to non-users, suggesting the body adapts within 12 months. However, you shouldn’t wait—focus on nutrient-rich foods from the start.
What nutrients are most important to watch on GLP-1 medications?
Research identified five nutrients as most likely to be lacking: folate (leafy greens), iron (red meat, beans), niacin (chicken, tuna), potassium (bananas, sweet potatoes), and vitamin B6 (chickpeas, salmon). Prioritize these in your meals.
Does everyone on GLP-1 medications develop nutritional deficiencies?
Not everyone, but the study found that most short-term users had inadequate intake of at least one nutrient. Long-term users showed better patterns, suggesting that awareness and dietary adjustments can prevent deficiencies.
Want to Apply This Research?
- Track daily intake of key nutrients identified in this study: folate (goal: 400 mcg), iron (goal: 8-18 mg depending on age/sex), niacin (goal: 14-16 mg), potassium (goal: 2,600-3,400 mg), and vitamin B6 (goal: 1.3-1.7 mg). Log foods eaten and see weekly nutrient totals to identify gaps.
- If using a GLP-1 medication, set a weekly reminder to eat at least 3 servings of iron-rich foods (red meat, beans, spinach), 3 servings of folate-rich foods (leafy greens, asparagus, lentils), and 3 servings of B-vitamin rich foods (whole grains, chicken, mushrooms). Use the app to plan meals that hit these targets.
- Create a ‘GLP-1 Nutrition Check’ monthly review where you compare your nutrient intake to recommended amounts. If you’re consistently below 80% of recommended intake for any nutrient, flag it for discussion with your doctor. Track this alongside your weight and energy levels to see if nutritional improvements correlate with how you feel.
This research describes observed patterns in eating habits among GLP-1 medication users and does not prove that the medication directly causes nutritional deficiencies. Individual nutritional needs vary based on diet, health status, and other factors. If you are taking or considering a GLP-1 receptor agonist medication, consult with your healthcare provider or a registered dietitian before making changes to your diet or starting supplements. Do not stop taking prescribed medications without medical guidance. This article is for educational purposes and should not replace professional medical advice.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.