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Loss of muscle is a concern with low calorie dieting such as The Omaha Weight Loss Diet and GLP-1 agonist use

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Long term prescription of medications such as the following are likely to increase the cause of, or exacerbate the risk of B12 deficiency - the proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole), famotidine, ranitidine, metformin, glibenclamide, gliclazide, glimepiride, glipizide, sodium valproate, gabapentin, doxycycline, some oral contraceptives