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The NHS advises against very low calorie diets (VLCDs) of fewer than 800 kcal per day unless they are medically supervised

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Second, what monitoring would look like in practice

Certain medications such as Metformin, H2-receptor antagonists including Zantac (Ranitidine), Tagamet(Cimetedine), Famotidine, Pepcid AC (Oral Pepcid), Axid AR (Nizatidine), Proton pump inhibitors (PPIs)including Prilosec (Omeprazole), Nexium (Esomeprazole), Prevacid (Lanzoprazole) and Antacids e.g:Gaviscon can also affect your ability to absorb vitamin B12