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Acquired causes of B12 deficiency can be 1) dietary, especially in vegetarian and vegan populations, 2) autoimmune, as seen in pernicious anaemia, where there is destruction of IF-producing parietal cells mediated by autoantibodies, 3) iatrogenic secondary to disruption of the acid-base status of the stomach (e.g., with proton pump inhibitor use or metformin), and 4) caused by malfunction of the terminal ileum (e.g., inflammatory bowel diseases like Crohns disease, gastric bypass or surgical resection)

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Rehman, J., Lazer, S., Benet, A

Some of the treatments will involve controlled small dosages every week or some may include larger doses of Vitamin B12 every month

Some small studies suggest B12 (especially with B6) may reduce nausea, though more research is needed [*]

This makes it distinct from appetite-suppressing compounds, where weight loss depends on maintaining a caloric deficit.