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

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.