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If you mix the powder directly into Vaseline or any oil-based cream, it will not dissolve and will leave a gritty, powdery residue on the skin, as you correctly anticipated

Approximately 70-80% of participants on Wegovy lost more than 5% of their body weight

Hill AS, et al

If I suspect an autoimmune cause for vitamin B12 deficiency (as covered earlier when discussing pernicious anaemia), I can request anti-intrinsic factor antibodies

Red Flags That Should Prompt Serious Reconsideration Warning Signs of Potentially Problematic Programs: Unrealistic Promises: Guarantees of specific weight loss amounts or speeds ("lose 30 pounds in 30 days") Claims that everyone will achieve dramatic results Suggestions that medication alone is sufficient without lifestyle changes Marketing language promising effortless or easy weight loss Inadequate Medical Evaluation: Prescribing without any medical evaluation beyond payment processing No provider review of medical history before prescription approval Inability to identify or name actual provider who will review your case Automated approval systems without human medical review Quality and Transparency Concerns: Inability or unwillingness to name specific compounding pharmacy partners Vague or evasive answers about quality control procedures and testing Refusal to provide certificates of analysis or batch testing documentation No clear information about medication source, formulation, or ingredients Missing or inadequate labeling on medication containers Questionable Business Practices: High-pressure sales tactics or artificial urgency ("offer expires today") Time-limited pressure to enroll without adequate time for consideration Billing practices that seem deceptive, confusing, or designed to obscure costs Difficulty reaching customer service or getting questions answered Overwhelmingly negative reviews highlighting safety or quality concerns Lack of transparent information about regulatory compliance and licensing Provider Accessibility Issues: No clear pathway to speak with actual healthcare providers Only customer service representatives available without medical training Providers never available for questions or consultations after initial prescription No way to reach provider outside business hours for urgent concerns Legal and Regulatory Concerns: Operating in states where they don't appear to have proper licensing Unclear about whether they comply with telehealth regulations Cannot clearly explain their corporate structure and provider relationships Unwilling to provide terms and conditions or user agreements for review Missing required privacy policies or HIPAA compliance documentation Question-Asking Framework: Legitimate, patient-centered telehealth programs should welcome detailed questions and provide clear, honest, comprehensive answers without defensiveness

Table of Contents Why Vitamin B12 Deficiency Can Occur After Gastric Banding How Gastric Banding Affects Vitamin B12 Absorption Recommended Dosage and Frequency After Bariatric Surgery Signs Your B12 Levels May Need Monitoring Long-Term Nutritional Follow-Up After Gastric Banding Scientific References Frequently Asked Questions Why Vitamin B12 Deficiency Can Occur After Gastric Banding B12 deficiency after gastric banding is primarily caused by reduced tolerance of B12-rich foods and use of acid-suppressing medicines