glp/gip/glucagon & cagrilintide 8mg/2mg Eli Lilly's Phase 3 clinical studies investigating retatrutide, the "triple-G" agonist, have found that long-term use can achieve substantial weight loss. Read about the work via the link in the comments semaglutide and cagrilintide dosage CagriSema

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Lastly, if you are not responding to oral B12 then you may want to consider using B12 shots

BPC-157 + NAD+ BPC-157 accelerates tissue repair by upregulating growth factor signaling (VEGF, EGF), promoting angiogenesis, and modulating nitric oxide pathways

Leptin produced by joint white adipose tissue induces cartilage degradation via upregulation and activation of matrix metalloproteinases