We clearly needed more research to understand the benefits and risk of longer-term phentermine use. We studied nearly 14, phentermine users, 8 in 10 of whom were women. Obesity starts at a BMI of Three in 10 of them were prescribed phentermine for more than 3 months.
At 6 months, a year, and 2 years after starting phentermine, weight loss was clinically significantly greater among people who used the medication longer-term more than a year or medium-term more than days but less than a year than in people who used it for only 3 months.
The people who used phentermine continuously for more than a year had kept off more than 7 percent of their baseline weight at 2 years. About a third of people prescribed phentermine lost less than 3 percent of their weight within the first 3 months of starting the drug. As far as safety goes, we expected to see an increase in blood pressure, but instead found that systolic blood pressure was reduced at 24 months in long-term users of phentermine relative to short-term users.
In this article, we look at what the current research says about phentermine, if it helps with weight loss, recommended dosages, and how to use it. The National Library of Medicine note that people should only use the drug for a few weeks. Phentermine stimulates certain brain chemicals that tell the body it is full. This may curb appetite sooner and help a person eat less. It is a complementary therapy for people who find it hard to lose weight after they make the diet and lifestyle changes to support a moderate weight.
In many cases, phentermine helps people lose weight. Since its approval in , it remains one of the most popular prescription weight loss drugs, either alone or as part of a combination therapy. The exact mechanism of how phentermine helps suppress appetite is unclear. Researchers suggest the drug increases neurotransmitter levels in the brain, which decreases hunger. This includes regular exercise, calorie restriction, and a healthful diet.
These changes alone are often enough to cause weight loss, though phentermine may enhance these effects. For example, a study in Obesity notes that phentermine may boost the efforts of some diet programs. This research notes that people who replaced one meal per day to reduce their calorie intake lost weight. And those who added phentermine to their program lost more weight and had fewer cravings. Phentermine is for people with obesity or those unable to lose weight with a balanced diet and exercise alone.
They should have a BMI over 30 , or over 27 with a weight-related condition. Importantly, a person should still make dietary and lifestyle changes to support their weight loss for the drug to work correctly.
Phentermine is also a short-term drug. Some studies report the safety of phentermine in long-term use, but it is still intended for a few weeks of use. There are risks with phentermine, and a doctor will discuss them before they prescribe the drug for weight loss.
Phentermine alone or in combination with other drugs, such as topiramate , may have their own risk of side effects, including:.
In some cases, these drugs may also make someone unable to drive or operate heavy machinery. Doctors recommend that people take time away from work when they first start the drug, to gauge any side effects. Accessed Jan. Perreault L. Obesity in adults: Drug therapy.
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This equates to a weight loss of 10—20 pounds 4. In a meta-analysis of six studies, people who took the average dose of While phentermine has been shown to be effective for weight loss , it may work better when combined with topiramate Topiramate is a drug that has been used on its own to treat seizures but — like phentermine — also has appetite-reducing properties 11 , 12 , In users, this weight loss has translated to a significant decrease in waist circumference, improved insulin sensitivity , and blood sugar control, as well as favorable effects on triglyceride and cholesterol levels 16 , Studies confirm the effectiveness of phentermine for weight loss.
The combination of phentermine and topiramate may help reduce binge eating in people with binge eating disorder BED and bulimia nervosa. BED is characterized by eating large amounts of food, often quickly and to the point of discomfort. Bulimia nervosa involves the same binge-eating behavior as with BED, but includes behaviors, such as self-induced vomiting, in an attempt to compensate for the effects of binge eating In a small week study in obese or overweight people with BED, the phentermine and topiramate drug combination was associated with significant reductions in weight, BMI, and binge-eating episode frequency In another week study, people with BED or bulimia nervosa were randomized to receive the drug combination or a placebo.
The same results were not observed in the placebo group The phentermine and topiramate combination has been shown to reduce binging episodes and weight in people with BED and bulimia nervosa. You should avoid taking the last dose too late in the day to prevent insomnia or difficulty falling or staying asleep.
Phentermine and topiramate — sold under the brand name Qsymia — is a combination medication used for weight loss 11 , This medication is available in four doses, ranging in strength from 3. After taking the lowest dose for 14 days, your doctor can choose to progress you to a higher dose. Phentermine alone is designed for short-term use only, as there are no long-term studies on its safety. However, the FDA has approved phentermine in combination with topiramate for long-term use, since the dosage of the two ingredients is lower than the maximum doses of the individual drugs
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