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Low levels of vitamin B12 can lead to: Depression Fatigue Poor memory Tingling sensation in the extremities Mania and psychosis (at extreme levels of deficiency) Permanent damage to the brain and nervous system (from long-term deficiency) Common causes of vitamin B12 deficiency include poor absorption (due to age, pernicious anemia, atrophic gastritis, Crohns Disease, long-term use of acid-reducing drugs, etc.) and vegetarian/vegan diets that limit the consumption of meat, dairy, and seafood

Clinical trials showed average weight loss of about 12% of body weight over 72 weeks

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The new label includes references to some of those postmarketing risks, including intestinal obstruction, [and] severe constipation including fecal impaction. Some patients who took Zepbound have filed lawsuits, accusing Eli Lilly of failing to properly warn them that Zepbound could increase their risk of severe gut problems, including bowel obstructions, pancreatitis, and gastroparesis

Positioning and patient behaviour People living with obesity increasingly self-direct their care given the long-term, chronic nature of their condition