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Weight loss surgery (gastrectomy) may obliterate many of the parietal cells and lead to a condition that mimics pernicious anemia where you simply dont have enough intrinsic factor

[DOI] [PMC free article] [PubMed] [Google Scholar] 158.Lynes MD, Leiria LO, Lundh M, Bartelt A, Shamsi F, Huang TL, et al

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So, if any individual notices these symptoms over a long period of time despite efforts to rectify them, they should consult their doctor and ask for measuring vitamin B 12 levels