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Certain prescription medications, including antacids and anti-diabetic medicines like metformin can cause vitamin B12 deficiency An endocrine-related autoimmune disorder, such as thyroid disease or diabetes Eating a vegetarian or vegan diet and excessive consumption of alcohol Certain gastrointestinal disorders, such as Crohns disease or Gastric bypass surgery or removal of part of the stomach Brain related disorders such as anxiety, depression, irritability and even poor concentration and general restlessness Heart and blood-related problems, increased risk of infections, improper growth in children and complication during pregnancy If you are a strict vegetarian, take vitamin B12 supplements

Traditionally, farmed animals would have got their B12 from water and eating food from the ground but with so many now confined in factory farms, animals themselves are given B12 supplements

This method ensures that the body receives the vitamin directly, making it immediately available for use

These include: Lifestyle interventions (dietary advice, physical activity programmes) Licensed pharmacotherapy such as orlistat, or GLP-1 receptor agonists including semaglutide 2.4 mg (Wegovy, NICE TA875) or tirzepatide (Zepbound) where clinically indicated and available Referral to tier 3 or tier 4 weight management services , including bariatric surgery assessment where appropriate Information on NHS weight management services and eligibility for licensed treatments is available via the NHS website and NICE guidance