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patient in intramuscular arm provide appointments for injections Visit 2 (week 8) Anamnesis: record lifestyle habits and use of alcohol Symptoms: if pathological at the first visit, record paresthesia, asthenia, loss or reduction of appetite, sadness or change in level of happiness, and concomitant pharmacological treatment Physical examination: if pathological at the first visit examine for Hunters glositis, positional and vibrational sensitivity Record concomitant treatment Request analyses to be performed one week before next visit: haemogram and serum vitamin B12 Questionnaires: EuroQoL-5D Assessment of adverse effects Therapeutic plan: patient in oral arm provision of medication

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Injections bypass absorption issues in the gut, delivering B12 directly into muscle for rapid effect

The STEP trials also showed that weight loss continued throughout most of the treatment period, with most participants still losing weight at 68 weeks