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The concerns about long-term safety are real and, so far, unresolved

Methionine is an essential amino acid, but too much of it can raise blood levels of another amino acid called homocysteine, and the process of breaking down homocysteine increases the body's need for B vitamins (thus increasing the risk of B vitamin deficiency even if your intake is adequate)

Many surgeons want weight stability first so the results hold

Whether this carries clinical significance requires longer-term cardiovascular outcome data that is not yet available

Bile duct injury: This is a serious but rare complication, occurring in around 1 in 500 Cholecystectomies