使用GLP-1减肥药需警惕营养缺陷风险

澳大利亚约50万人使用GLP-1类药物治疗糖尿病1。这类药物通过调节食欲激素有效管理血糖和体重，但伴随而来的营养健康风险日益引起关注。

GLP-1药物的减重效果显著，但副作用不容忽视。血清素1毫克周剂量平均能减轻体重6.24公斤，替扎帕肽15毫克周剂量减轻14.8%1。这些药物的常见胃肠道副作用包括恶心（21%）、腹泻（10%）、呕吐（9%）和消化不良（9%）1。使用者全天能量摄入可减少3036至3581千焦耳1，快速体重下降的同时，营养摄入面临严重风险。

更令人担忧的是，这类药物可能引发多种营养缺陷，包括硫胺素（维生素B1）缺乏可导致不可逆脑损伤、代谢性酸中毒和血镁严重过低1。2025年流行歌手Robbie Williams公开表示，在服用减肥药后患上了坏血病1。

为确保营养摄入均衡，使用者应通过记录饮食日记、咨询营养师等方式进行监测，并遵循澳大利亚《健康饮食指南》的建议：每餐应包含半盘蔬菜沙拉、四分之一盘瘦蛋白和四分之一盘米面土豆面包1。

GLP-1 receptor agonists such as Ozempic and Mounjaro have become widely used medications, with approximately 500,000 people in Australia taking these drugs to manage diabetes, alongside a larger population using them for obesity treatment 1. These medications work by regulating appetite hormones and have demonstrated significant weight loss benefits, though they carry important nutritional health risks that users must understand.

The weight reduction achieved by these drugs varies by medication and dosage. Semaglutide at a 1 mg weekly dose produces an average weight loss of 6.24 kilograms, while tirzepatide at 15 mg weekly can reduce weight by up to 10.8 kilograms 1. At higher doses, semaglutide at 2.4 mg weekly results in approximately 10.2% weight loss, increasing to 12.6% at 7.2 mg, while tirzepatide achieves 9.5% weight loss at 5 mg, 12.4% at 10 mg, and 14.8% at 15 mg 1. A buffet experiment demonstrated that lunch energy intake decreased by an average of 1,132 kilojoules compared to baseline levels, representing a 25-33% reduction 1.

Despite their effectiveness, GLP-1 drugs frequently cause gastrointestinal side effects. According to a review of 48 studies, nausea affects 21% of users, diarrhea 10%, vomiting 9%, indigestion 9%, and constipation 8%, with nausea identified as the most common adverse effect across a 33,000-person meta-analysis 1. More critically, rapid weight loss associated with these medications can lead to serious nutritional deficiencies, including thiamine (vitamin B1) deficiency, which can cause irreversible brain damage, metabolic acidosis, and severe hypomagnesemia 1. In 2025, singer Robbie Williams reported developing scurvy after using weight-loss medication, highlighting real-world nutritional complications 1.

Users of GLP-1 drugs are advised to maintain balanced nutrition by following guidelines such as filling half their plate with vegetables, one quarter with lean protein, and one quarter with grains, potatoes, or bread 1. Healthcare professionals recommend that patients keep food diaries and consult with nutritionists to ensure adequate nutrient intake, particularly during periods of rapid weight loss 1.