The Dangers of Type B Malnutrition: What You Need to Know

You have all probably heard of the new class of weight loss medications known as GLP-1 receptor agonists, and more recently GLP-1 and GIP dual agonists, have gathered a lot of attention. I personally have a strong cohort of patients in clinic who are doing very well on these drugs. Some patients having lost over 3 stone and have normalised their BMI and substantially reduced their cardiovascular risk.

The drugs were initially developed to treat type 2 diabetes, drugs like semaglutide (marketed as Ozempic and now  Wegovy) and liraglutide (Saxenda) have gained widespread popularity for their effectiveness in promoting weight loss. More recently, Mounjaro (tirzepatide) has emerged as a favourite among these medications. Unfortunately as they are available on line, and their restricted criteria  for use is often  overlooked some of these patients are slipping through the monitoring net.

These drugs work by mimicking the action of certain hormones—primarily GLP-1 (glucagon-like peptide-1)—that play a key role in regulating blood sugar and appetite. GLP-1 increases insulin production when blood sugar is elevated, slows the emptying of the stomach (so helps you feel fuller for longer), and reduces appetite, leading to fewer calories consumed.

What sets Mounjaro apart is its unique ability to target two hormones critical for blood sugar regulation and metabolism:

1. GLP-1 (Glucagon-Like Peptide-1): This hormone boosts insulin production when needed, delays gastric emptying, and curbs your appetite.

2. GIP (Glucose-Dependent Insulinotropic Polypeptide):  While also enhancing insulin secretion like GLP-1, GIP has the added benefit of improving fat metabolism. By engaging both GLP-1 and GIP, Mounjaro not only aids in blood sugar control but also enhances more effectively than drugs targeting GLP-1 alone.

So firstly with Appetite suppression  it reduces hunger and helps you feel satisfied with smaller meals, leading to reduced calorie intake and subsequent nutrient intake.

Secondly you are Improving your fat metabolism: The GIP component of the drug may play a role in promoting fat burning, making it easier for you to lose weight.

And finally slowing down your gut transit time digestion you will experience longer periods of satiety, reducing your desire to eat and snack between meals. 

While these drugs have shown impressive results in helping people shed pounds, we have started noticing a concerning side effect: Type B malnutrition.

Have you heard of Type B Malnutrition?

This refers to micronutrient deficiencies—a lack of vitamins and minerals essential for the body’s normal functions. Unlike Type A malnutrition, which is related to a lack of calories (under-eating), Type B is about not getting enough key nutrients like vitamins (e.g., B12, D), iron, calcium, or magnesium.

These weight loss drugs, in their pursuit of suppressing appetite and making people eat less, are indirectly contributing to this problem. As you eat less food, you are probably consuming fewer nutrients that are crucial for maintaining your health. Over time, this can lead to deficiencies that may cause issues like fatigue, anaemia, bone weakness, or nerve damage.

So what is causing this Malnutrition?

1. Reduced Food Intake:  Yes, these classes of drugs help reduce hunger, making you feel full faster and eat smaller portions. While this is great for weight loss, it often means you aren’t eating enough nutrient-rich foods, like fruits, vegetables, lean proteins, and whole grains. The result? You aren’t getting the necessary vitamins and minerals.

2. Gastrointestinal side effects.  One of the most common side effects of these drugs cause nausea or gastrointestinal discomfort, which can make you even less likely to eat balanced meals. And if you are avoiding food because of discomfort, you are at an increased risk of missing out on key nutrients.

3. Inadequate Nutrient Absorption: While the main issue stems from eating less, there is also some evidence that GLP-1 /GIP drugs may slow down gastrointestinal motility.  This can impact how well the body absorbs certain nutrients, especially in the long term.

Why Does This Concern You?

The human body needs a variety of vitamins and minerals to function properly. For example:

- Vitamin B12 is critical for nerve function and making red blood cells.

- Calcium and vitamin D are essential for maintaining strong bones.

- Iron helps transport oxygen in the blood, preventing fatigue and anaemia.

When you lose weight, you may initially feel better because of the reduced burden on their bodies. However, if these micronutrient deficiencies go unchecked, you could face long-term health consequences that may offset the benefits of weight loss.

What CAN YOU DO ABOUT IT?

It’s not all bad news—Type B malnutrition caused by GLP-1 drugs can be managed with the right steps:

1. Nutrient-Dense Foods: Even when your appetite is suppressed, focusing on nutrient-rich foods like leafy greens, nuts, seeds, and lean proteins can help ensure you get the vitamins and minerals they need.

2. Supplements: For those of you who find it difficult to eat enough food, a multivitamin or specific supplement can help cover nutrient gaps. Always consult a doctor before starting any supplements.

3. Regular Monitoring: Healthcare providers should monitor you if you are on weight loss drugs for signs of nutrient deficiencies through regular blood work, especially if you are using the medication long term.

Conclusion

 These weight loss drugs have provided many people with a new way to manage obesity, but they come with some unintended consequences. As more people turn to these medications, the rise of Type B malnutrition is something that healthcare providers—and patients—need to be aware of. By eating nutrient-rich foods and monitoring their health, people can enjoy the benefits of weight loss while minimizing the risks of vitamin and mineral deficiencies. 

The key is finding balance: losing weight without losing nutrition.

 If you are interested in having a chat about weight loss or supplements please get in touch.

Criteria for our weight loss program at River Aesthetics

• Adults with obesity (typically defined as a BMI of 30 or higher).

• Adults who are overweight (BMI of 27 or higher) and have at least one weight-related condition, such as hypertension, type 2 diabetes, or dyslipidemia.

• Patients who have not been able to lose weight through lifestyle changes alone.

For more information please DM me

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