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NICE Technology Appraisal guidance (TA875 for semaglutide/Wegovy and TA664 for liraglutide/Saxenda) recommends these medications for weight management in adults with: A body mass index (BMI) of at least 35 kg/m and At least one weight-related comorbidity (such as type 2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea, or non-alcoholic fatty liver disease) For liraglutide (Saxenda), NICE TA664 specifies additional criteria including prediabetes (HbA1c 42-47 mmol/mol or fasting plasma glucose 5.5-6.9 mmol/L) or high risk of cardiovascular disease

However, high B12 levels are more often linked to liver or kidney problems, not B12 toxicity

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From a healthcare system perspective, the availability of oral GLP-1 drugs may also influence prescribing patterns