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This is not an isolated problem

The observed upregulation of not only the ThDP-dependent dehydrogenases limiting and feeding the TCA cycle, but also the thiamine transporters and ThDP-producing enzyme TPK1 (Figures 4B, 5B), may compensate for decreased levels and/or increased demands of thiamine in enterocytes 69 months after gastric bypass, facilitated by the higher expression of the proteins binding thiamine or ThDP

Traffic Research 2002

Dosing started at 0.6 mg per day and increased by weekly 0.6 mg increments to mitigate gastrointestinal side effects

However, SGLT2 inhibitors cause substantially less weight loss than expected from the energy excreted via glycosuria, because it elicits an adaptive increase in energy intake, including compensatory increases in appetite/caloric intake [40]

2016;352:i610