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Moreover, low levels of B12 reduce the supply of oxygen, which leads to a decrease in the RBC count

However, specific circumstances warrant prompt consultation: Contact your bariatric team if you experience : Significant weight regain : Regaining more than 1520% of lost weight or returning to within 5% of pre-operative weight (follow your team's specific guidance) Inadequate initial weight loss : Losing less than 50% of excess weight within 1218 months post-operatively Persistent hunger : Experiencing constant or severe hunger despite appropriate portion sizes Loss of restriction : Ability to consume significantly larger portions than in the early post-operative period Nutritional deficiencies : Symptoms such as fatigue, hair loss, brittle nails, or neurological changes suggesting vitamin deficiencies Gastrointestinal symptoms : New or worsening nausea, vomiting, reflux, or abdominal pain Psychological difficulties : Depression, anxiety, eating disorders, or body image distress affecting quality of life Comorbidity recurrence : Return of obesity-related conditions such as type 2 diabetes, hypertension, or sleep apnoea Before starting weight loss injections , discuss with your bariatric team: Your weight loss trajectory and realistic expectations Potential benefits and risks specific to your medical history Alternative strategies that may be appropriate Funding and access pathways, as NHS provision varies by region Monitoring requirements and long-term treatment plans Emergency situations requiring immediate medical attention include: Severe, persistent vomiting or inability to tolerate fluids Signs of dehydration (dark urine, dizziness, rapid heartbeat) Severe abdominal pain or suspected surgical complications Symptoms of acute pancreatitis (severe epigastric pain radiating to the back, with vomiting) Signs of gallbladder disease (right upper quadrant pain, fever, jaundice) Symptoms of hypoglycaemia (confusion, sweating, tremor) if using diabetes medications Your bariatric team can provide personalised guidance on whether weight loss injections are appropriate for your individual circumstances and can coordinate comprehensive care to support your long-term success