How Penn Nursing researchers are ahead of the curve

(Reprinted in part, with permission from Penn Nursing Magazine Fall 2024)

By Madeleine Kates

Ozempic® and Wegovy®, Mounjaro® and Zepbound® — these GLP-1 agonists and others, originally approved by the U.S. Food and Drug Administration in 2005, have been all over the media, by turns called wonder drugs and cautionary crazes.

Penn Nursing is on the cutting edge when it comes to studying GLP-1s and has been for years, uncovering myriad ways these medications impact the body, including new applications for their use. The original intent for GLP-1 medications was for treating diabetes, but their efficacy as a weight management drug means researchers like Colleen Tewksbury, PhD, MPH, RD, CSOWM, LDN, Assistant Nutrition Science Professor, are looking closely at how people are using these drugs to treat overweight and obesity, and their impact on micronutrient deficiencies resulting from weight loss. Little to no evidence currently exists in that area, and Tewksbury aims to fill this research gap.

Tewksbury and her team are analyzing dietary quality data, and studying micronutrient changes associated with rapid weight loss being seen in patients on GLP-1 medications. Micronutrients are important for overall health, cognitive, and physical function, and deficiencies can lead to illness or injury, according to the U.S. Centers for Disease Control and Prevention.

Tewksbury says that since using these medications for weight loss is so new, there are no recommendations available yet for accompanying nutrition care. For patients receiving bariatric surgery, however, monitoring is a key component of their ongoing care. Because GLP-1 medications are self-administered and can result in weight loss without behavioral modifications, patients may achieve their desired weight loss goal while placing other aspects of their health at risk.

Tewksbury’s team is examining data and assessing blood samples from patients who achieved weight loss due to sleeve gastrectomy bariatric surgery to determine dietary quality, changes in iron, calcium, parathyroid hormone, and vitamins D, B1, and B12. “Our goal is to make sure that if patients are experiencing rapid weight loss, they are doing so safely, and we want to understand what their nutritional support needs may be during this process,” says Tewksbury.

As with any medication, there can be side effects with GLP-1s, such as nausea and vomiting, which can be obstacles to treatment, dosing, and medication adherence. Bart C. De Jonghe, PhD, Professor of Nutrition is investigating why these medications, meant to improve a patient’s health, often make them ill. “The side effects of any medication are going to impact how long a person stays with their course of treatment,” says De Jonghe.

He and his colleagues were among the first researchers to study GLP-1s, and have published approximately two dozen papers on this class of medications over the past 15 years. His focus is on why their use can cause nausea and vomiting, and to also unlock the mechanisms by which they reduce weight. Meanwhile, he continues to refine existing treatment uses for GLP-1s and hopes to create new ones.

Madeleine Kates is a recent graduate of Penn Nursing’s MSNS program.