Always discuss significant dietary or lifestyle changes with your healthcare team, particularly if you have existing medical conditions or take regular medications
For patients with genetic variants affecting B12 metabolism or impaired liver function, methylcobalamin is preferable
Real-world effectiveness Studies examining real-world outcomes show that results are typically somewhat lower than in clinical trials but still significant: A 2025 Cleveland Clinic study found average weight loss of 10-15% in routine clinical practice (compared to 15-22% in trials)
Although Bbs5 / mice showed no differences in body weight at weaning compared to age-matched WT or heterozygous littermate controls, the KO mice began gaining adiposity at a significantly faster rate after 4 weeks of age, eventually becoming visibly larger than mice in both control groups (Figure 1A) Bbs5 / mice exhibited significant hyperphagia in both the light and dark phases compared with WT controls (Figure 1B), leading to increased body weight from 8 weeks of age (Figure 1C) and fat mass compared with WT littermate controls starting from 6 weeks of age (Figure 1D)
Indeed remittance from diabetes experienced by RYGB or SG patients, has been attributed to the elevation of circulating bile acids (37, 38, 357), warranting further investigation, especially the development of gut-restricted TGR5 agonists (358)
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