# Micronutrient Deficiencies in the Era of Second-Generation Incretin-Based Therapies for Obesity

## TL;DR

This review discusses how second-generation obesity drugs may affect micronutrient levels in people with obesity, who are already at risk for nutritional deficiencies.

## Contribution

The paper provides a comprehensive overview of micronutrient risks associated with incretin-based therapies and suggests strategies for nutritional monitoring.

## Key findings

- Obesity is associated with a high prevalence of baseline nutritional inadequacy.
- Incretin-based therapies may reduce dietary intake and alter micronutrient exposure.
- Risk-stratified nutritional monitoring is recommended during these therapies.

## Abstract

Second-generation incretin-based therapies have transformed the pharmacological management of obesity by inducing substantial and sustained weight loss. The weight-reducing effects are primarily mediated through appetite suppression, reduced energy intake, and modulation of eating behavior. While therapeutically beneficial, these mechanisms may also influence dietary quality, micronutrient exposure, and overall nutritional status, particularly in individuals with obesity, a population already characterized by a high prevalence of baseline nutritional inadequacy. This narrative review is intended to inform clinicians, clinical nutrition specialists and researchers involved in obesity management by summarizing baseline micronutrient vulnerability in obesity, synthesizing available evidence on dietary intake, biochemical micronutrient status, and nutrition-related clinical outcomes during incretin-based therapy, discussing plausible mechanisms linking these therapies to micronutrient risk, and outlining approaches to risk-stratified nutritional monitoring in clinical practice.