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According to FDA prescribing information, gastrointestinal symptoms vary by formulation and dose, with higher rates at weight-management doses

The Specific Binding of the Platelet-Activating Factor (PAF) Receptor Antagonist WEB 2086 and the Benzodiazepine Flunitrazepam to Rat Hepatocytes

Gastroenterology (2011) 140:90312

Formulations of cyanocobalamin injection containing benzyl alcohol as a preservative should also be avoided in premature neonates and those with hypersensitivity due to its association with gasping syndrome.[15][16][20] Monitoring: A history of the patients allergies/hypersensitivity should be obtained before administering cyanocobalamin injection

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its a metabolic consequence of excess weight