The emergence of weight-loss medications such as Ozempic and Mounjaro has significantly impacted the global obesity epidemic. However, experts are now cautioning that these drugs may be contributing to a revival of scurvy, a disease historically associated with pirates and believed to be a relic of the past.

Australian researchers have highlighted concerns that these medications, used by roughly one in eight Americans, may leave many users in a state of dangerous malnutrition, thus increasing the risk of scurvy and other health issues.

An analysis of 41 studies, encompassing over 50,000 individuals, revealed that while weight loss was the primary focus, only two studies assessed participants’ diets for nutritional deficiencies.

Dr. Clare Collins, a leading researcher in nutrition and dietetics who spearheaded the study, emphasized, “These medications are effective, without a doubt. However, losing weight doesn’t necessarily equate to being well-nourished or healthy. Nutrition is a vital component of overall health, and it is currently being overlooked in the available research.”

Dr Clare Collins, a nutrition and dietetics researcher who led the paper, said: ‘These medications work, there’s no question about that. 

‘But a reduction in body weight does not automatically mean the person is well nourished or healthy. Nutrition plays a critical role in health, and right now, it’s largely missing from the evidence.’

Doctors are already reporting a rise in cases of scurvy in the US, a disease caused by a vitamin C deficiency, triggered by eating too few fruits and vegetables, where the gums swell, turn purple and start to bleed. 

Once rife in the 17th and 18th centuries among sailors deprived of fresh produce, the disease is estimated to have claimed the lives of more than 2 million sailors in Britain alone.

Scurvy was once only linked to pirates. The above image is an 18th century American print of pirates capturing a ship

Robbie Williams revealed he had developed scurvy after taking a drug ‘similar to Ozempic’

In the US, officials already estimate that at least seven percent of Americans are deficient in vitamin C, and experts fear weight loss drugs could accelerate the trend.

Scurvy typically develops in one to three months after suffering from a vitamin C deficiency, the Cleveland Clinic says.

Left untreated, as well as causing bleeding in the gums and loosened teeth, the condition can also cause bleeding under the skin, easy bruising, leg swelling, and dry, brittle hair that coils like a corkscrew.

Doctors treat the condition by giving patients more vitamin C via supplements and encouraging them to eat a diet containing more fruits and vegetables. Most patients feel better within 48 hours and recover completely within two weeks.

In serious cases, however, the disease can lead to permanent damage to the gums and loss of teeth.

Collins warned that she was contacted by doctors during the research, saying they were recording the disease in weight-loss drug patients.

She added: ‘Let’s not wait for every [doctor] to see a case of scurvy, let’s get on the front foot and link these [doctor] chronic management plans to a dietitian referral.’

Doctors warn that the drugs raise the risk because they virtually eliminate someone’s appetite, causing them to eat less and raising the risk of a deficiency. They also trigger side effects such as nausea, vomiting and constipation, which may make users less likely to consume food.

Many patients take the drugs for months or years, raising the risk of a chronic nutrient deficiency that would further raise the risk of the disease.

Weight loss drug users are advised to eat a high-protein and balanced diet while on the drug to prevent nutrient deficiencies and to lift weights to minimize muscle loss, although doctors report many patients do not follow this advice.

Former Olympic athlete and celebrity personal trainer Sarah Lindsay, pictured, has also raised concerns that weight loss drugs could cause scurvy

Rock singer Robbie Williams, 51, was diagnosed with scurvy after taking an appetite-suppressant described as ‘similar to Ozempic’.

He revealed the diagnosis in April last year, after he stopped eating and lost 28lbs while on the drug, taking his weight from 195 to 169lbs.

He told The Mirror: ‘I’d stopped eating and I wasn’t getting nutrients.

‘With body dysmorphia, when people say they’re worried about how you’re looking, you’re like: “I’ve achieved it”. When people say, “we’re worried you’re too thin”, that goes into the head as, “jackpot. I’ve reached the promised land”.’

Williams did not detail his symptoms, but said that, while on the medication, he had felt sad, depressed and exhausted. 

Former Olympic athlete and celebrity personal trainer Sarah Lindsay, whose clients have included Piers Morgan and Ellie Goulding, has also warned that weight loss drugs could cause a wave of scurvy.

She told The Sun: ‘The level of abuse now is rife, thin people wanting to become even thinner.

‘I’ve had people come in for PT consultations who are desperate to get themselves out of the hole they find themselves in: Weak, tired, destroyed digestion, severe hair loss.’

She added: ‘My… worry is the long-term effects of being malnourished… or even a comeback of a deficiency disease like scurvy.’

In her review published in the BMJ, Collins, who is based at the Newcastle School of Health Sciences in New South Wales, analyzed trials on GLP or GIP receptor medications published over the last 17 years.

Lindsay fears the increased use of injections like Ozempic and Mounjaro could lead to a return of scurvy (stock image)

Only one study had published data on diet. After contacting all the authors, a second study also sent her the data. 

She said: ‘We wrote to all the authors and got the data from one more trial. This is being missed. 

‘It does not give you an opportunity on how [the weight loss drugs] might impact their dietary intake. We know there are a lot of side effects. For such an expense, it is a marked miss.’

Other researchers have also linked weight loss drugs to other deficiencies, such as a lack of thiamine, a nutrient from pork, fish and legumes that supports nerve function, leading to neurological and heart complications.

Patients have also had protein deficiencies while on the drugs, which doctors have said it’s led to them losing more muscle than fat.

Collins warned that without robust data on diet, researchers could not fully understand the broader effects of weight loss drugs like Ozempic and Wegovy.