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And for more rapid improvement intramuscular therapy is used, and it must be considered in patients with severe deficiency or severe neurologic symptoms

(Dali-Youcef and Andrs, 2009) Other people at risk include those who have had intestinal surgeries, or have chronic conditions which affect the gut , such as Crohns disease or celiac disease (Dahele and Ghosh, 2001)

The weight loss results proved impressive - 24-week trials showed average 10.6% weight loss at 1mg daily dose compared to 2% placebo, with some participants losing 15-20%