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The authors of one trial (95) included in the above-mentioned meta-analysis (89) noted that little cognitive decline was observed in the placebo group over their two-year trial, which may have limited their power to detect an effect of the B-vitamin intervention (95)

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Consider intramuscular vitamin B 12 injections instead of oral replacement for suspected or confirmed vitamin B 12 deficiency caused by diet if: The person has another condition that may deteriorate rapidly and have a major effect on their quality of life (for example, a neurological or hematological condition such as ataxia or anemia)

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These combined effects create an optimal cellular environment for fat metabolism, energy production, and metabolic health

Contrave trials did not report significant numbers of participants reaching this level of weight reduction