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What the Published Data Shows Across the research literature, B12 deficiency rates after bariatric surgery fall in the following ranges (3): Roux-en-Y gastric bypass: approximately 2% to 80%, depending on follow-up duration and supplementation Sleeve gastrectomy: 0% to 36.4%, with deficiency often emerging up to two years post-surgery Biliopancreatic diversion with duodenal switch: highest rates, often requiring lifelong parenteral supplementation Weight loss medications: up to 2.6% incidence within one year of treatment These are wide ranges because research has pooled studies with very different follow-up windows and supplementation regimens