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216 (2020): 165-172.e4

According to the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) Obesity Clinical Practice Guidelines, all patients undergoing weight loss therapy should be monitored for mood disorders, depression, and suicidal ideation

Medications that interfere with B12 absorption (e.g., metformin, proton pump inhibitors)

It's that the rules change significantly from state to state

Modern processed foods, including fortified breakfast cereal , often contain synthetic cyanocobalamin that requires extensive conversion processes to become bioactive methylcobalamin

Low energy production may result in general body fatigue