Zenodo · Jan 27, 2026
Uncovering Nutritional Deficiencies and the Adequacy of Wrap-Around Care for Patients on GLP-1 RAs: A quality improvement audit
By Ammineni D, Ottolini M, Ray S et al.
Background: Glucagon-like peptide-1 receptor agonists (GLP1-RAs) are effective treatments for obesity and Type-2 diabetes, but concerns remain about malnutrition risks with inadequate support. There is no established framework for nutritional screening, dietary assessment nor supplementation for GLP1-RAs users. This study evaluated dietary intake and the quality of support for patients prescribed GLP1-RAs in a primary care setting. Methods: A mixed-methods quality improvement audit was conducted at a single NHS GP practice in Northamptonshire, UK. Fourteen adults prescribed GLP1-RAs within the past 12 months completed dietary recalls using the validated myfood24 platform and semi-structured telephone interviews. Dietary intake was compared against UK reference nutrient intakes (%RNI). Interviews were analysed thematically to explore patient experiences of GLP1-RAs use and support received. Results: Whilst prescribed GLP1-RAs, mean daily caloric intake was ~1,300 kcal, with two participants consuming <800 kcal/day. Fibre intake averaged 44.9% of the RNI, while intakes of iron (64.2%), magnesium (79.0%), potassium (68.9%), and vitamin D (39.7%) were consistently below targets during the period assessed (mean days recorded = 4). In contrast, protein intake frequently exceeded requirements (mean 152% RNI). Ultra-processed foods comprised 33% of dietary intake, (lower than the UK population average). Qualitative analysis revealed major gaps in medical follow-up and dietary guidance: several participants relied on online peer groups, reported uncertainty about basic nutrition and described significant appetite suppression leading to meal skipping. While many reported relief from “food noise” and improved self-compassion, others experienced social withdrawal, financial anxiety, and fear of weight regain. Conclusion: Patients using GLP1-RAs may fail to meet key nutrient requirements despite exceeding protein targets, with many receiving minimal structured support. More research is needed to assess the size of this problem and the health impacts of potentially failing to meet key nutritional requirements. This is a preprint and has not yet been released as a peer-reviewed publication.