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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

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Others spread the daily dose into 2-3 doses, taken in the morning and prior to physical exercise, in both cases on an empty stomach

Other symptoms of vitamin B12 deficiency Beside numbness and tingling in your hands or feet you may experience the following ( 1 ): brain fog or difficulty with thinking and memory loss fatigue weakness problems with walking, coordination, or balance swollen, inflamed tongue yellow skin (jaundice) paranoia or hallucinations How do you know if you are deficient in vitamin B12