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The absorption of vitamin B12 requires something called intrinsic factor, which is a protein found in stomach acid

10.1021/acsnano.2c10830 37 GargM.JohriS.SagarS.MundhadaA.AgrawalA.RayP.et al (2021)

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Together, these mechanisms produce the 15-20% average body weight loss seen in the clinical trials, results that changed what the medical community considered possible with pharmacological intervention

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Arakawa R, Febres G, Cheng B, Krikhely A, Bessler M, Korner J