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Obesity is associated with macrophage accumulation in adipose tissue

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This is not just cosmeticvisceral fat is metabolically active and strongly linked to insulin resistance, fatty liver, and cardiovascular disease

Side effects followed the pattern typical of incretin-based therapies

Summary: Vitamin B12 injections after gastric banding are indicated when oral supplementation fails to correct a documented deficiency, neurological symptoms are present, or the patient cannot adhere to daily oral regimens

Jumping straight to 100+ mg daily can increase side effects like nausea or fatigue