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Vitamin B12 absorption begins in the mouth but mainly occurs in the stomach and small intestine with the help of intrinsic factor, a protein that helps your body absorb B12. Weight loss surgery results in anatomical changes, such as a smaller stomach, reduced stomach acidity, and changes to the small intestine, that can lead to vitamin B12 malabsorption and decreased intrinsic factor secretion

doi: 10.1089/gtmb.2013.0309

This article was researched against primary regulatory, trial, prescribing, and manufacturer sources where available

In deficiency, the body makes abnormally large, inefficient cells (megaloblastic anemia)