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Scheme 31

Obesity classes (adult, per NHLBI): Class 1 obesity: BMI 30.034.9 Class 2 obesity: BMI 35.039.9 Class 3 obesity (morbid/severe): BMI 40.0 Pediatric obesity is defined differently

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Evidence Strength Rating Moderate plausibility via reduced intake Limited direct clinical outcome data 4.2 Vitamin B12 Physiological Role Vitamin B12 supports: Neurological function Red blood cell production DNA synthesis It is primarily obtained from: Meat Dairy Fish Why GLP-1 Therapy May Influence B12 Possible mechanisms: Reduced intake of animal products Chronic low-calorie intake Gastric acid modulation secondary to delayed gastric emptying (theoretical) Unlike metformin, GLP-1 drugs are not known to directly impair B12 absorption

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Dietary modifications, including allulose substitution, typically yield 35% weight loss without additional behavioral or medical support