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Because both semaglutides effects and alcohol can irritate the gastrointestinal tract, combining them makes these unpleasant symptoms more likely

Britten RA, Green JA, Warenius HM

6 In obesity without diabetes (a 72-week trial, ~3,127 participants), mean body-weight change reached roughly 7.5%, 8.4%, and 11.2% at 6, 12, and 36 mg versus about 2.1% with placebo on the treatment-regimen estimand, with the highest dose reaching approximately 12.4% (about 27 lb) on the efficacy estimand, accompanied by improvements in cardiometabolic risk markers

Since the body cannot produce B12 on its own, obtaining an adequate amount through diet or supplementation is essential