Hi!
I need to get another perspective on what happened yesterday and how I'm feeling about being denied a continued blessing of a drug. I've been on Mounjaro since October 2022. I reached maintenance a little while ago.
40(F), 5'3, HW: 292 in 2021, SW: 276 in 2022, CW: 123
I've been maintaining with 7.5mg. My last visit with her was August last year. I was 137, so I've lost 14 more pounds since then. I had a 6 month follow up with my endo yesterday. I told her how much better I felt and that I'd been maintaining since December, taking a shot every 1-2 weeks depending on loud the noise gets. I asked her if I could get a refill for the lower dose of whatever she was willing to prescribe because if I've had great success with the 7.5mg spacing it out somewhat, maybe I'd be able to titrate down to maintain. Insurance covers Zep and W with prior authorization. She said no, because:
1) I've lost too much weight and had nothing left to lose (I'm not losing anymore. we'd never discussed an actual goal weight but I ended up making my own goal of just being in the normal range when I saw it was actually working) 2) that I should be able to maintain my lifestyle now 3) that this is not a lifetime drug 4) that this medicine does not dissolve fat, but rather makes people choose healthier food options (not a single word on how it targets hormones, which is what it really does)
She dx'd me originally as obese due to excess calories. I honestly feel that was the wrong dx simply because I don't believe they (any of my doctors) did a full work up. The reason why I say this is because I started seeing a new primary provider and she ordered full labs and I saw on there tests I'd never seen before, including insulin resistance. I'm normal but I'd assume it's because of the Mounjaro. My 17yo son is insulin resistant. Diabetes runs on both sides of the family. I am literally the only one on both sides of my family that was obese and not full blown diabetic, but was pretty dang close to it. I have never been able to lose weight with diet and exercise starting from 2002 at 160 to 2021 at 292. I steadily gained. I had always been a chunky, although very active, kid. As far as I know, I'm now in the normal range for a 40yo female now. I've eaten mostly the same as I always have (I eat mostly vegetarian and meat substitutes, but 100% I am my dad's daughter so I've got the mad sweet tooth as well), but much smaller portions and I know when to stop now.
She was the one who asked me if I'd truly wanted to lose weight (obviously! That's why I saw her, was to find out if I had any hormonal imbalance and to fix it if I did) and suggested Mj after she had me try phentermine and a version of Contrave (was already on 300mg Wellbutrin, she added 25mg naltrexone). Between those, I didn't even lose a full 20lbs so I do feel that obviously it wasn't just a problem with appetite.
I'm upset because I know the noise will come back. It always does, but I can cut it off with the shot. I am terrified of having to go through the whole cycle again. I'm happy now. I have energy. I can play with my 4yo without huffing and puffing and pouring sweat and hating my entire existence. I'm don't feel bad going out in public with my family. I'm "normal." I feel like I'm justified being upset for those reasons and more, but I also feel like I should just be thankful I even got to do this and shut my mouth.
Please be kind. It's such a small problem, but it's bothering me so much. I know it's ridiculous.

So, you're curious about PhenQ, right? And there are no real, authentic user testimonials and lot of promotion going around.
First off, full transparency here – I'm an affiliate and reseller of PhenQ over at PowerandBulk.com. Now, before you raise your eyebrows, hear me out.
The one thing I want to add is because I've got the data and seen firsthand how PhenQ customers keep coming back for more. We're talking repeat sales, folks. This is something most reviews don’t tell!
That tells us PhenQ isn't just another bottle on the shelf; it's making some real difference for people.
Who's PhenQ for, you ask? Well, if you've been struggling with weight loss, hitting plateaus no matter how hard you try, PhenQ might be your ally.
It's designed for anyone who's looking for a boost in their weight loss efforts, needing that extra edge to burn fat, suppress appetite, and even improve mood and energy levels.
And the USP? It combines multiple weight loss benefits/mechanisms into one pill, tackling your weight loss battle from all angles. We're talking fat burning, appetite suppression, energy boosting, and mood lifting. Plus, it's formulated with ingredients backed by science.
So, if you're on the lookout for a weight loss supplement that covers more ground than most, PhenQ might be what you need.

PhenQ alternatives: What else?

HERE is a brief summary, of what else is available and what kind of product options you have besides Phenq,
1. Best appetite suppressants with natural ingredients- PhenQ , Phen24 and Instant Knockout Cut
Try Phen24 for 24x7 weight loss formula, day & night-time fat burning, Instant Knockout for its powerful, excellent glucomannan + caffeine combo for appetite suppression and more energy boost. Burn-xt from Amazon is also good!
2. Best for women : PhenQ (with caffeine) and HourGlassFit (without caffeine, non-stimulant fat burner for women)
HourGlassFit in particular is quite reobust formula for non-stimulant fat burning. It you are a woman & sensitive to caffeine, like can't sleep on it, go for HourGlassFit instead of PhenQ.
3. Best for fitness pros and enthusiasts, fat burner for workouts – Instant Knockout Cut and Phena-Lean
4. Best for 24*7 weight loss (day and night-time fat burning) : Phen24
4. Most diverse ingredients profile phentermine substitute/weight loss pill without caffeine (Best Doctor formulated ingredients & hormones targeting) product – Lean Optimizer
5. Best Phenq alternatives on Amazon: Burn-XT and Phenelite

Key Ingredients of PhenQ and Their Benefits

• a-Lacys Reset®: A blend of alpha lipoic acid, cysteine base, and magnesium, a-Lacys Reset® is marketed for its potential to accelerate metabolism and increase thermogenesis. However, the direct impact on weight loss can vary significantly from person to person.
• Capsimax Powder: While studies suggest that capsaicinoids in Capsimax powder can enhance thermogenic abilities and fat burning, the actual slimming effect might not be as dramatic for everyone, depending on individual metabolism and lifestyle factors.
• Chromium Picolinate: Chromium is known to help reduce cravings for sugar and carbs, which could be beneficial for weight management. Yet, its effectiveness can be subtle and not a standalone solution for weight loss.
• Caffeine: A well-known stimulant, caffeine can boost energy and focus while supporting fat burning through thermogenesis. However, sensitivity to caffeine varies, and some may experience jitters or disrupted sleep patterns.
• Nopal Cactus: High in fiber, nopal cactus may aid in feeling fuller longer and reducing fat absorption. While promising, its impact should be complemented with a balanced diet for noticeable weight loss.
• L-Carnitine Fumarate: This ingredient supports turning fat into energy, potentially reducing fatigue. The effectiveness largely depends on overall lifestyle and dietary habits.
• INNOSLIM: A patented blend claiming to enhance weight loss by stimulating fat-burning hormones and reducing carbohydrate absorption. While innovative, the real-world impact might require further independent studies to fully validate these claims.
• B-Vitamins: Including B3, B6, and B12 to support metabolism and energy production is a smart move, yet the contribution to weight loss is more supportive than direct. A deficiency in these vitamins can hinder weight loss efforts, but supplementation alone is not a cure-all.
• Iodine: Essential for thyroid hormone production and a balanced metabolism, iodine supplementation can support weight loss, especially in those with deficiencies. However, its effectiveness is contingent on the individual's thyroid health status.

All in all, while PhenQ's ingredients have potential benefits for weight loss and energy support, their impact can vary widely among individuals. It's important to approach this supplement with realistic expectations and consider it as part of a broader weight management strategy.

PhenQ User Reviews and Testimonials

User Experiences: It's a mixed bag, honestly. Some folks swear by PhenQ and we have lot of repeat sales. It's been kind of a game-changer for their weight loss journey if they’re feeling more energetic, less hungry, and seeing the pounds drop over time. But then, there are others who didn't see much change at all. It seems like for every person who lost weight, there's another who didn't notice any difference.
Ease of Use: Most users agree that PhenQ is pretty straightforward to use. Just a couple of pills a day. No complicated schedules or dietary restrictions, which is a plus.
Side Effects: Here's where things get a bit dicey. While many users didn't report any side effects, there's a significant number who might experience some discomfort, especially with caffeine based fat burners like this. Jitters, upset stomach, and headaches were the most commonly mentioned. A few folks also talked about having trouble sleeping, probably due to the caffeine content. It's clear that while PhenQ tries to be a one-size-fits-all solution, individual reactions can vary a lot.
Overall Satisfaction: On the whole, satisfaction levels are all over the place. Some users are absolutely thrilled with the results, praising PhenQ for helping them lose weight when nothing else worked. Others, though, feel like they wasted their money, seeing little to no results. The consensus? PhenQ might work wonders for you, but it's not a guaranteed success.
So, if you're thinking about giving PhenQ a try, my advice would be to go in with your eyes open. It could be exactly what you need, but be prepared for the possibility that it might not live up to your expectations.

PhenQ Performance Evaluation (Overall rating: 3.9/5)

Appetite Suppression: 4/5
PhenQ contains ingredients like nopal cactus and chromium picolinate, which are known for their appetite-suppressing properties. Nopal is high in fiber, which can increase the feeling of fullness and reduce hunger, while chromium helps manage blood sugar levels, potentially reducing cravings. These components make PhenQ quite effective in this category, though individual results may vary. Also consider Instant Knockout for solid appetite suppression.
Metabolism Boost: 3/5
The inclusion of a-Lacys Reset®, a blend of alpha-lipoic acid and cysteine, along with capsimax powder, positions PhenQ as a supplement capable of enhancing metabolic rates. These ingredients are believed to stimulate thermogenesis, leading to increased calorie burn. However, the overall impact on metabolism might not be as significant for everyone, depending on various factors like diet, lifestyle, and individual metabolic differences. Also consider Phen24 and HourGlassFit for solid metabolism boost.
Energy Enhancement: 3.5/5
Caffeine, a well-documented stimulant, is a key component of PhenQ, known for its ability to boost energy levels, reaction times, and reduce fatigue. This along with α-Lacys Reset® , L-Carnitine Fumarate and B vitamins makes PhenQ fairly effective in enhancing energy, especially useful for supporting increased physical activity and exercise. However, the rating is not a full 5 due to the potential for caffeine sensitivity among some users, which could limit its effectiveness or lead to undesirable side effects like jitters or insomnia.
Stimulant-like Effects: 3/5
PhenQ contains caffeine, a well-known stimulant, which can provide a moderate boost in alertness and energy. However, the effects might not be as pronounced as stronger stimulants found in other weight loss supplements. This makes it a middle-ground option for those who want some stimulant benefits without the intensity that can lead to jitters or sleep disturbances. For stronger stimulant-like effects consider Phenalean.
Fat Burning: 4/5
With ingredients like Capsimax powder, α-Lacys Reset® and chromium picolinate, PhenQ is designed to enhance the body's thermogenic processes and improve insulin sensitivity, respectively, which can contribute to fat burning. These ingredients, supported by research, suggest PhenQ could be quite effective in this category, although individual results will vary.
Safety Profile: 4/5
PhenQ's use of mostly natural ingredients like nopal cactus and α-Lacys Reset® positions it as a safer option among weight loss supplements. However, the inclusion of caffeine means it might not be suitable for everyone, especially those sensitive to stimulants. Overall, its safety profile is strong, but as with any supplement, it's important to consider personal health conditions and consult with a healthcare provider. Phen24 and HourGlassFit are also comparatively safer formulae.
User Reviews: 3/5
The consensus from user reviews of PhenQ is decidedly mixed. Many users report positive outcomes, including weight loss, increased energy, and reduced appetite. However, there's a significant portion of users who didn't see the results they were hoping for, citing minimal to no weight loss even after consistent use. This disparity in experiences suggests that while PhenQ can be effective for some, it's not a universal solution for weight loss.
Price ($69.9): 2.5 /5
At $69.9, PhenQ is positioned at the higher end of the market in terms of price for weight loss supplements. While it offers a comprehensive formula that targets various aspects of weight loss, the cost may be prohibitive for some users, especially considering the mixed reviews regarding its effectiveness. For those on a tight budget or unsure about investing in a weight loss supplement, the price point of PhenQ might be a significant deterrent.

PhenQ alternatives (which one should you try? Based on your goals)

If you're on the hunt for a PhenQ alternative or just exploring your options, I've got some insights that might help you decide which path to take. Here's the lowdown from someone who's been there:
1. Best with Natural alternatives and Positive User Reviews: If you're looking for something with a solid reputation, great user reviews, and acts as a solid appetite suppressant then apart from PhenQ, also consider Phen24 (24x7 fat burning formula) and Instant Knockout Cut (excellent glucomannan + caffeine combo). Also consider Burn-xt which you can get from Amazon, a solid diet pill as well!
2. Best for Women: Ladies, if you're in search of a supplement tailored for you, PhenQ offers a caffeinated kick, apart form that go for HourGlassFit , which is your go-to if you prefer a non-stimulant option and tailored for women.
Also Phenelite; which you can get form Amazon, it's another solid choice that's been popping up in conversations.
3. Best for Fitness Pros and Enthusiasts: For the gym rats and fitness fanatics, Instant Knockout Cut and Phena-Lean might be better suited than PhenQ, designed to fuel your workouts and maximize fat burning. Many have leaned towards Instant Knockout Cut for that extra energy during lifting sessions.
4. Best for 24/7 Weight Loss: If the idea of burning fat even while you're dreaming sounds good, Phen24 is the way to go. It's crafted to work day and night, with multiple formulae ensuring your weight loss efforts don't hit pause when you do.
5. Most Diverse Ingredients Profile: For those who prefer a scientifically-backed, doctor-formulated approach, Lean Optimizer stands out. It targets hormones and boasts a diverse ingredient profile, making it a unique player in the weight loss game.
6. Best Weight Loss Pills on Amazon: And for my fellow Amazon shoppers, Burn-XT and Phenelite are the top picks. Easy to order and with plenty of reviews to sift through, these options are convenient and highly rated by users.
If you're looking for a weight loss supplement, my advice is to consider your lifestyle, needs, and any sensitivities or preferences you might have (like avoiding caffeine).

Pricing and Availability:

• PhenQ: Sits at around $69.9 for a month's supply. It's not the cheapest ticket in town, but it's packed with a range of benefits that might justify the cost for many. You can snag it directly from their official website, which is always my go-to move to ensure I'm getting the real deal and can take advantage of any deals or bundles they're offering.

Price Comparison with Other Supplements:

• Phen24: Priced similarly to PhenQ, Phen24 offers that unique day and night formula, aiming for 24/7 weight loss support. If round-the-clock fat burning sounds appealing, the price might seem more palatable.
• Instant Knockout: Geared towards the fitness enthusiasts among us, Instant Knockout is in the same ballpark, price-wise. It's a favorite for those looking to boost their workout results, making its cost a worthwhile investment for the gym rats.
• Hourglass Fit: Tailored for women and without the caffeine kick, Hourglass Fit is slightly cheaper. If you're looking for a gentler option that's kind on your wallet, this could be it.
• LeanBean: Another female-focused supplement, LeanBean's price is on par with PhenQ. It's celebrated for its appetite suppression, making it a solid choice for those who struggle with snacking.
• Burn-XT: A more budget-friendly option available on Amazon. If cost is a major factor for you, Burn-XT offers a decent entry point into weight loss supplements without breaking the bank.
• PhenRX: Typically cheaper than PhenQ, PhenRX is an option for those looking to dip their toes into weight loss supplements without committing to a higher price tag.

Where to Buy PhenQ:

Your best bet is the official PhenQ website. Not only does this ensure you're getting an authentic product, but you'll also find detailed information, customer support, and sometimes, pretty sweet deals or bundles that aren't available elsewhere.

Pros of PhenQ:

• Comprehensive Approach: One thing I love about PhenQ is its all-in-one formula. It's not just about burning fat; it also suppresses your appetite, boosts energy, and even helps improve mood. If you're looking for a multi-faceted approach to weight loss, PhenQ might be your jam. [Rated high among natural phentermine options]
• Science-Backed Ingredients: The ingredients aren't just pulled from a hat. Compounds like α-Lacys Reset® have some solid science behind them, promising to help with fat loss and muscle mass. It's reassuring to know there's some real research backing up those claims.
• Energy Boost Without the Crash: Unlike some supplements that leave you jittery, PhenQ provides a nice energy boost that doesn't end in a crash. It's been a game-changer for my mid-afternoon slumps.

Cons of PhenQ:

• Price Point: Let's be real – PhenQ isn't the cheapest option out there. At around $69.9, it's a bit of an investment. If you're tight on budget, this might make you think twice.
• Caffeine Content: While the energy boost is great, the caffeine content might not be everyone's cup of tea, especially if you're sensitive to caffeine or like to enjoy your actual cup of tea (or coffee) too.
• Mixed User Reviews: Like any supplement, results vary. While some folks rave about the changes they've seen, others haven't noticed much difference. It's a bit of a gamble, and what works like a charm for one person might not for another.

Bottomline
PhenQ has its fair share of fans and critics. If you're in the market for a weight loss supplement that tackles multiple aspects of weight loss and are willing to invest a bit more for quality, PhenQ could be worth a shot. Just keep in mind the caffeine content and the fact that individual results may vary.

What Natural Alternatives to Ozempic Should I Consider? Are There Alternatives to Berberine?

In my quest to find a natural alternative to Semaglutide (Ozempic or Wegovy), a medication used for managing type 2 diabetes (wegovy is specifically prescribed for weight loss), I’ve come across several herbs and ingredients that are commonly found in A1C supplements aimed at naturally lowering blood sugar levels and activating the AMPK enzyme. "Nature's Ozempic" is a term that caught my eye, referring to natural substances that might mimic the effects of Ozempic.
Among the various options, Berberine, Gymnema Sylvestre, and Fenugreek have shown promising evidence of their potential anti-diabetic effects. But the exploration doesn’t stop there; there are several other herbs, ingredients, and over-the-counter (OTC) supplements that have been historically or scientifically linked to diabetes and metabolic health improvement.
Here’s a curated list of potential OTC, non-prescription, natural supplements that seem to come closest to the effects of Ozempic or GLP-1 agonist drugs, ranked based on their potential impact.
If you are looking for weight loss supplements with special emphasis on insulin support or blood sugar management, energy support & managing cravings, the following list of ingredients are your best bet.
So, make sure you go for a multi-ingredient product that uses a combination of below ingredients!
Now these can be taken as single-ingredient products too, like you could get high quality Berberine HCL and Fenugreek pretty cheap at BulkSupplements.com, However, if I were to look for something more strong & focused on weight loss, I would go for PhenQ or Blood Sugar Optimizer.
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1. Berberine - Berberine is a compound found in several plants that may help regulate glucose and lipid metabolism, acting as a natural alternative to Ozempic.
2. Gymnema Sylvestre - Gymnema Sylvestre is a herb that may reduce sugar absorption in the intestines, offering a natural approach to managing blood sugar levels.
3. Fenugreek - Fenugreek seeds may help in improving insulin function, making it a potential natural alternative for blood sugar management.
4. Cinnamon - Cinnamon is known to improve insulin sensitivity and has antioxidant properties, making it beneficial for blood sugar control.
5. Bitter Melon - Bitter melon contains compounds that mimic insulin, helping in the regulation of blood sugar levels as a natural alternative.
6. Ginseng - Ginseng may enhance the release of insulin from the pancreas and improve insulin receptors, offering natural support for blood sugar management.
7. Alpha Lipoic Acid - Alpha Lipoic Acid is an antioxidant that may improve insulin sensitivity and reduce symptoms of nerve damage in people with diabetes.
8. Chromium - Chromium is a mineral that may enhance the action of insulin and support the metabolism of carbohydrates, fats, and proteins, making it a potential natural alternative for managing blood sugar levels.
9. Turmeric - Turmeric contains curcumin, which may have anti-inflammatory effects and the potential to improve insulin sensitivity, offering a natural approach to blood sugar management.
10. Astragalus - Astragalus is a herb that may help improve metabolic function and insulin sensitivity, acting as a natural alternative in managing blood sugar levels.
11. Ginger - Ginger may help reduce fasting blood sugar levels and improve A1c (a measure of long-term blood sugar control), making it a beneficial natural alternative for blood sugar management.
12. White Mulberry - White Mulberry leaves may help lower blood sugar levels by reducing the absorption of sugar in the gut, acting as a natural alternative for blood sugar management.
13. Maqui Berry - Maqui Berry is rich in antioxidants and may help reduce blood sugar levels, supporting natural glucose metabolism.
14. Juniper Berry - Juniper Berry may help lower blood sugar levels by improving the pancreas's insulin-secreting functions, offering a natural approach to managing diabetes.
15. Biotin - Biotin, a B-vitamin, may help enhance insulin sensitivity and increase glucose metabolism, acting as a potential natural alternative for blood sugar management.

From a personal standpoint, I would carefully evaluate each of these options, considering their historical and researched use in managing diabetes and overall metabolic health. It’s essential to delve into the scientific evidence supporting their effectiveness and safety. This article on Outlook and this one on Dr.Axe.com also specifically focus on the above ingredients.

My evaluation: Best Natural Alternatives to Ozempic

I’ve encountered few noteworthy options that stand out due to their unique blends of ingredients aimed at managing blood sugar levels and weight. Here’s a closer look at what I found:
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1. PhenQ

Main Ingredients: Nopal cactus, Alpha Lipoic acid, and Chromium
Best For: Weight loss, Appetite suppression, Managing Cravings
PhenQ isn’t merely an over-the-counter (OTC) alternative to Ozempic; it’s also recognized as a natural alternative to phentermine. It’s a multifaceted weight management supplement designed to burn fat, suppress appetite, boost energy, and balance mood.
The Nopal cactus, one of its main ingredients, is traditionally celebrated for its health benefits, particularly in blood sugar control. It contributes to PhenQ’s effectiveness by providing dietary fiber that moderates blood sugar spikes, enhancing insulin sensitivity, and combating oxidative stress.
Combined with other ingredients like Alpha Lipoic Acid and Chromium, PhenQ mimics metabolic and appetite-suppressing effects similar to Ozempic, making it a compelling choice for those seeking natural alternatives.
All in all, one of the most unique natural alternative to Ozempic or Wegovy, especially if you are looking for weight loss! [Source]
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1. Amiclear

Main Ingredients: Gymnema Sylvestre, Astragalus & Ginseng
Best For: Balanced blood sugar levels, Weight loss, Glycemic control
Amiclear is another natural supplement that caught my attention. It’s formulated to help individuals achieve balanced blood sugar levels through a blend of traditional herbs.
Ingredients like Gymnema Sylvestre reduce sugar absorption, while Astragalus supports sugar metabolism, and Ginseng enhances blood sugar uptake. These ingredients work synergistically, positioning Amiclear as a "Nature's Ozempic" available over the counter.
Each ingredient in Amiclear, from African Mango known for weight loss benefits to Guarana that boosts energy, plays a role in supporting metabolic health, making it a valuable option for those seeking natural ways to manage blood sugar levels.

3. Blood Sugar Optimizer

Main Ingredients: Berberine, Fenugreek seed extract, Cinnamon & Resveratrol
Best For: A comprehensive approach to blood sugar regulation and metabolic health
Blood Sugar Optimizer presents itself as a compelling choice with a blend of ingredients like Berberine, Fenugreek extract, and Cinnamon Extract, among others. These ingredients collectively aim to offer metabolic and blood sugar-regulating effects akin to Ozempic.
· Berberine: Known for improving insulin sensitivity and reducing sugar production in the liver, Berberine stands out for its anti-diabetic effects.
· Gymnema Sylvestre Extract: This herb, native to India, is rich in gymnemic acids that reduce sugar absorption and enhance insulin function, showcasing its potent benefits.
· Cinnamon Extract: Specific cinnamon extracts in the formula aim to enhance insulin sensitivity and lower blood sugar, offering a natural approach to blood sugar management.

4. GlucoTrust

Main Ingredients: Juniper Berries, Cinnamon, and Gymnema Sylvestre
Best For: Achieving healthy blood sugar levels, improved blood flow, glucose metabolism, reduced sugar cravings, and enhanced sleep
GlucoTrust is another natural supplement that has caught my attention. It’s formulated to support healthy blood sugar levels, promoting various health aspects such as healthy blood flow and reduced sugar cravings.
· Juniper Berries: These berries may enhance insulin sensitivity and release, supporting overall metabolic health with their anti-inflammatory and antioxidant properties.
· Chromium: Included in the formula, Chromium accelerates metabolism and enhances insulin sensitivity, contributing to efficient glucose metabolism in the body.
· Manganese and Zinc: These minerals aid in converting blood sugar to energy and promoting insulin production, supporting overall metabolic health.

5. GlucoBerry

Main Ingredients: Maqui berry and Gymnema
Best For: Addressing the "Blood Sugar Drain" issue, particularly the clogging of the kidneys by SG2
GlucoBerry takes a distinctive approach by focusing on the body’s "Blood Sugar Drain" system, aiming to prevent the clogging of kidneys by a substance referred to as SG2 (Sodium-Glucose Cotransport 2). This clogging hinders the kidneys from effectively flushing out excess sugar, leading to elevated blood sugar levels.
· Maqui Berry: Rich in an antioxidant called Delphinidin, Maqui Berry is central to GlucoBerry’s formula. Delphinidin helps inhibit the production of SG2, aiding in unclogging the "Blood Sugar Drain" and allowing for effective elimination of excess sugar.
· Gymnema: Along with other ingredients like Chromium and Biotin, Gymnema is included in the formula to further support blood sugar regulation.

6. Altai Balance

Main Ingredients: White Mulberry, Bitter Melon, Banaba, Juniper Berries
Best For: Preventing insulin spikes and enhancing the body's insulin response
Altai Balance incorporates ingredients like White Mulberry, known for its potential to slow carbohydrate digestion and prevent insulin spikes, thereby supporting blood sugar regulation.
· White Mulberry: This ingredient may enhance insulin sensitivity, combat oxidative stress, and boost insulin efficiency, making it a valuable component in managing type 2 diabetes.
· Additional Ingredients: Altai Balance also includes a blend of other supplements like Banaba and Alpha Lipoic Acid, further enhancing its ability to balance blood glucose levels.

7. Glucocil

Main Ingredients: Berberine, Mulberry, Cinnamon
Best For: A holistic approach to blood sugar & weight management
Glucocil stands out with a blend of 14 ingredients, aiming to support healthy blood sugar levels holistically. It focuses on various aspects of blood sugar regulation, such as reducing sugar absorption and enhancing the body’s utilization of sugar for energy.
· Mulberry Leaf Extract: Central to its formulation, this ingredient works to reduce sugar absorption from food.
· Berberine and Other Ingredients: Ingredients like Berberine, Gymnema Sylvestre, and Cinnamon enhance various aspects of blood sugar regulation, making Glucocil a comprehensive option for those seeking an all-encompassing solution.

8. Dr. Whitaker's Berberine GlucoGold

Main Ingredients: Berberine, Cinnamon, Chromium
Best For: A cellular approach to managing blood sugar levels and digestive wellness
Dr. Whitaker's Berberine GlucoGold offers a potent blend that focuses on a cellular approach to managing blood sugar levels. It combines Berberine with ingredients like concentrated cinnamon and a unique form of chromium to support metabolic and blood sugar regulation.
· Berberine: Present in a significant amount, Berberine enhances cellular processes that facilitate the transfer of glucose from the bloodstream into cells.
· Cinnamon and Chromium: These ingredients complement Berberine, supporting various aspects of metabolic health, glycemic control, and overall wellness.

Is Berberine The Go-To Natural Alternative to Ozempic?

Firstly, why has berberine caught our attention? It seems that social media platforms, like TikTok, have amplified its popularity, with viral claims about its weight loss benefits. Berberine is a plant-based compound, traditionally used in Ayurvedic medicine, and is now available in capsules and tablets. It has been researched for its potential to manage various health aspects such as blood sugar, cholesterol, and weight.
I found that berberine operates differently from Ozempic. While Ozempic works by making us feel full and slowing down food digestion, berberine activates an enzyme called AMP-activated protein kinase (AMPK). This enzyme plays a vital role in managing our blood sugar levels, but it doesn’t work in the same way as Ozempic.
From a user's perspective, I would consider the effectiveness and safety of berberine. Research suggests that berberine might have some modest effects on weight loss, but it’s not quite as pronounced as Ozempic. It’s essential to understand that berberine is not a direct substitute for Ozempic, and its long-term effects on weight loss are still a bit uncertain.
So, why is berberine becoming popular, and what benefits does it offer in terms of diabetes and weight loss? Berberine is believed to curb appetite and improve blood sugar levels. However, many claims about berberine’s benefits are not fully backed by extensive, peer-reviewed studies. A comprehensive review of various clinical trials indicates that berberine might offer some metabolic benefits, particularly for heart health, but with only minor weight loss advantages.
I would also advise considering the potential side effects of berberine, such as gastrointestinal issues like diarrhea and constipation, and its possible interactions with other medications, including those for diabetes. The lack of FDA regulation for berberine supplements is also something to keep in mind.

Qsymia, a remedy weight reduction medicine containing phentermine and topiramate, has acquired consideration as a successful answer for those trying to shed pounds. Nonetheless, not every person is a possibility for remedy weight reduction drugs, and many lean toward normal, over-the-counter (OTC) choices. In this article, we will investigate the top of the line normal OTC phentermine substitutes as options in contrast to Qsymia, offering powerful choices for your weight reduction venture.
In its generic form, Qsymia, or phentermine/topiramate, is a pharmacological compound commonly recommended for managing obesity.
Grasping Qsymia and Its Job
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Prior to jumping into elective arrangements, it's essential to comprehend what Qsymia is and the way in which it works. Qsymia is a physician recommended medicine essentially made out of two dynamic fixings: phentermine and topiramate. Phentermine is a hunger suppressant, while topiramate is an anticonvulsant that can assist with controlling seizures and headaches. Together, these fixings are accepted to advance weight reduction by lessening hunger and expanding the sensation of completion.
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Why Consider OTC Phentermine Options?
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While Qsymia can be powerful, it isn't appropriate for everybody because of its solution status and expected incidental effects. Besides, a few people incline toward normal choices without the requirement for a specialist's solution. OTC phentermine substitutes offer a characteristic and open way to deal with weight reduction without a similar degree of administrative oversight.
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Top of the line Regular OTC Phentermine Substitutes
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PhenQ: PhenQ is a well known OTC weight reduction supplement that impersonates the impacts of phentermine. It works by smothering hunger, supporting digestion, and advancing fat consuming. With fixings like caffeine, capsicum, and L-carnitine, PhenQ offers a characteristic way to deal with weight reduction.
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Phen375: One more OTC choice, Phen375, is intended to assist you with shedding pounds by expanding digestion and diminishing craving. It contains fixings, for example, L-carnitine, caffeine powder anhydrous, and cayenne pepper.
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Forskolin: Forskolin is a characteristic enhancement got from the base of the Indian coleus plant. It has acquired prominence for advancing weight reduction by expanding the creation of cyclic AMP, a particle that assumes a part in metabolism potential.
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Garcinia Cambogia: Garcinia cambogia is a tropical natural product extricate that contains hydroxycitric corrosive (HCA). A few examinations propose that HCA might assist with stifling hunger and hinder the capacity of fat in the body.
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Green Tea Concentrate: Green tea contains intensifies like catechins and caffeine, which have been displayed to support digestion and advance fat oxidation. Green tea extricate supplements are promptly accessible and offer a characteristic way to deal with weight reduction.
​
Picking the Right OTC Phentermine Elective
​
While considering OTC phentermine options, going with an educated decision is fundamental:
​
Counsel a Medical services Proficient: Prior to beginning any weight reduction supplement, talk with a medical care supplier, particularly in the event that you have hidden ailments or are taking prescriptions.
​
Understand Names: Painstakingly read the fixing marks to guarantee you are alright with the parts of the enhancement.
​
Screen Your Wellbeing: While at the same time utilizing an OTC phentermine elective, focus on your wellbeing and any likely secondary effects. Assuming that you experience unfriendly responses, cease use and look for clinical guidance.
​
Consolidate with a Solid Way of life: OTC enhancements work best when coordinated into a fair eating regimen and normal work-out everyday practice.
In its generic form, Qsymia, or phentermine/topiramate, is a pharmacological compound commonly recommended for managing obesity.
End
​
Taking everything into account, assuming you're looking for options in contrast to Qsymia, OTC phentermine substitutes can offer normal and available choices for your weight reduction venture. PhenQ, Phen375, forskolin, garcinia cambogia, and green tea separate are among the first class decisions accessible. Nonetheless, it's essential to focus on your wellbeing and talk with a medical services proficient prior to beginning any new enhancement routine. Recall that while these OTC options can be successful, they ought to supplement a sound way of life that incorporates legitimate sustenance and normal actual work for supportable weight reduction results.

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Fast Action Keto Gummies Reviews Are Australia's Action Keto Gummies Real or Fake?
There is a plenty of weight decrease arrangements available, each encouraging phenomenal outcomes. Notwithstanding, you should be particular in your determinations, since a considerable lot of these items neglect to follow through on their cases. Picking the right food varieties is fundamental for weight reduction. Fast Action Keto Gummies, then again, have been attempted and tried by genuine individuals who have seen genuine outcomes concerning fat consuming and craving concealment, so you might get them with certainty. They are ensured to work, so you might buy them with certainty.
What Are Fast Action Keto Gummies?
To support weight reduction, these Fast Action Keto Gummies might be utilized by anyone. These things utilize a concentrate from the Garcinia cambogia plant, which has been displayed to have fat-consuming characteristics. There is proof that rising metabolic rate and further developing generally speaking body synthesis may help with weight decrease.
Fatty oils, a sort of fat that might be available in the blood and in many substantial tissues, are likewise diminished. This makes it a promising treatment for diabetes.
Best Weight reduction Supplement. Instead of standard weight reduction helps like Phentermine, these desserts give a sugar-and sans gluten choice that is comparably compelling.
In what ways do they vary from each other?
Fast Action Keto Gummies is a dietary enhancement for the ketogenic diet that vows to assist you with losing the weight.
It contains beta-hydroxybutyrate (or BHB), the essential ketone body created by the liver during times of low starch ingestion.
To enter ketosis, eating a great deal of protein and fat consistently is important. The significance of restricting your sugar consumption, notwithstanding, couldn't possibly be more significant. This keeps your body consuming fat for fuel in any event, when you're not working out, which maintains a strategic distance from hazardous spikes in glucose.
To assist your body with entering ketosis all the more rapidly, have a go at taking these chewy candies in the first part of the prior day breakfast. Along these lines, you will not need to stress over adding additional calories or carbs to your eating routine during the day.
VISIT HERE TO KNOW ABOUT FAST ACTION KETO GUMMIES HOW TO WORK ON BELLY FAT!
For what reason would it be a good idea for one to consider using Fast Action Keto Gummies?
The parts of this medication, which are regular, were picked with care in order to totally fulfill you. It arrives in a helpful box with a perfect proportion of all that you'll need, and it's accessible at whatever point you decide to utilize it. Since it was made to work as one with your body, this recipe contains no counterfeit fixings or fillers of any sort. This item has no substances known to cause unfavorably susceptible responses, subsequently it is protected to consume.
Fast Action Keto Gummies are figured out to have an effect that advances ketosis inside the body. In this express, your glucose and fat levels are low, establishing a climate wherein fat might be singed thus characterizing your condition. As your endurance and strength develop and your weight fall, you will feel better and more fit than any other time. There is to a lesser extent an opportunity that one might gorge or get occupied while eating due to this substance's guide in hunger the executives. More than that, it keeps you side by side of the internal functions of your body by controlling your pulse and giving you constant updates. Your insusceptible framework's exhibition increments which might assist with warding off a large group of expected issues.
Which ingredients are utilized in Fast Action Keto Gummies?
Fast Action Keto Gummies are planned with a blend of all-regular fixings that synergistically initiate ketosis, a metabolically useful condition. It has a fat-consuming enhancement and sugar substitutes with less carbs. This synergistic mix might diminish desires, increment energy, and accelerate your digestion. This makes it an extraordinary choice for the people who are trying to cut calories.
Likewise, this medication takes out the dangers related with elevated cholesterol and circulatory strain, so you can quit agonizing over your wellbeing. Along these lines, you can be sure that the recipe behind Fast Action Keto Gummies was planned by specialists with the express objective of upgrading your weight reduction experience while additionally advancing your wellbeing and prosperity all the more extensively.
The two primary fixings are apple juice vinegar (ACV) and BHB. We've previously settled what BHB is, so how about we continue on toward ACV's capability.
This fixing is the most imperative for making the sticky bears the right consistency. While it contains some sugar, it is likewise wealthy in numerous other helpful components. You'll have more endurance to go during that time without failing spectacularly because of the micronutrients' part in poison end and keeping you at top wellbeing.
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How long until you get impacts from utilizing Fast Action Keto Gummies?
Get thin quick with the assistance of these Fast Action Keto Gummies. Involving this brand's enhancements notwithstanding your customary work-out routine can carry you to your wellness objectives all the more rapidly, yet you actually need to invest the energy.
The utilization of these confections has been connected by a few clients to a recognizable reduction in their weight list.
These chewy confections are loaded with supplements that synergistically act to help your digestion and help in fat consuming for ideal weight reduction results.
Many individuals who were first suspicious now unequivocally suggest Fast Action Keto Gummies since so many of their clients have announced extraordinary results in the wake of utilizing them.
What kind of weight decrease might be anticipated while utilizing Fast Action Keto Gummies?
Fast Action Keto Gummies give not one, yet two particular benefits: a weight reduction arrangement and a strong fat killer. Accordingly, you will actually want to achieve your objectives with them. Your digestion will be accelerated, and your body's energy levels will be improved, the two of which will help you in losing as much as 6 pounds each month with the use of the pills.
Prior to purchasing any of these pills, you ought to learn all that you can about the expected advantages and dangers related with utilizing them. The pills are totally ok for human use since they are created altogether from natural fixings. They are, consequently, totally sans risk for utilization. Manual for Appropriately Utilizing Fast Action Keto Gummies
If you have any desire to see weight decrease comes about because of using these chewy candies, you really want to take them consistently. In light of reason, it is pivotal that you plan your days to consider their day to day use. This is because of the way that they should be taken at specific times over the course of the day. If so, almost certainly, the Fast Action Keto Gummies will not give the guaranteed benefits.
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A Few Words in Conclusion
Fast Action Keto Gummies confections are ready to move on the authority site of the organization that makes them. Likewise, you might get your hands on this stuff from many stores, like Walgreens, Walmart, and bounty all the more other than. You might get a free preliminary container and limits on this Fast Action Keto Gummies item, yet provided that you get it through the authority site's internet based shop. You may likewise purchase the wholesome enhancement at any pharmacy or drug store in your locale and pay for it with cash or a Visa.

Trigger warning: mention of miscarriage
I believe I may be pregnant. Im panicking because of a failed pregnancy I had. It just dawned on me about three hours ago that I may be pregnant. I can’t get in with my gyno right now so I wanted to know if anyone could share what immediate steps I can take until I can get an appointment. I’m panicking. I’m not trying to get pregnant and we weren’t planning on it but it would be the miracle of my life 😭 and I just want to do my best to be healthy
I had a miscarriage at 8 weeks almost exactly two years ago so I’m very worried. I’m taking jencycla right now but ran out for about a week. During that time I had unprotected sex on January 23. According to Google, I wouldn’t see a positive test until February 13.
I know I should start a prenatal which I have here right now. Other than that, I want to know what to do/avoid to make the first few weeks safe until I find out if it’s true.
What I plan on doing:
I’m stopping my bc until I can test accurately. I’m starting a prenatal today. I’m eating whole food meals cooked at home and not drinking alcohol.
Concerns I have:
I just started taking phentermine for weight loss with PCOS. I have hypothyroidism and Hashimoto’s thyroiditis. I take metformin 2000 a day. I take Zoloft 200 a day. Are any of these harmful? I do little to no exercise. Is starting mild exercise daily too much of a change for my blood pressure? I suspect I have a mild case of POTS. Does this mean anything for my blood pressure regarding pregnancy?
Again I obviously plan on seeing my doctor as soon as I possibly can but due to my previous failed pregnancy so early, I am panicking. It just dawned on me today that I find these symptoms familiar; just got a UTI; I’ve been absolutely exhausted for a week or two; I’ve not had cravings due to the phentermine probably but last time I didn’t really either. I’m not nauseous but wasn’t last time. I started bleeding (last time I had a “period” around the time i estimate to be implantation). It’s a mild normal period for me.
Any help even a tad would be so highly appreciated by me. Thank you in advance and again I will go to the doctors at the very earliest possibility, I’m not substituting Reddit for medical care. 🤍

Controversial topic incoming! New MD ('22) here! I know that many people who are looking to lose weight would prefer a natural option without medication. But, prescription weight loss medication from a provider you have an established relationship with IN CONJUNCTION with lifestyle changes has a higher likelihood of producing sustainable results (AACE Guidelines). Taking any medication is a very personal decision, so please take this with a grain of salt and talk to a provider you trust. Also of note, many doctors are not comfortable prescribing medication for weight due to long standing stigma. This is just a passion project of mine, and something I've personally struggled with.
For each of these, I'll walk through a brief overview of the mechanism, landmark trials showing evidence it works and in what population, and side effects/side effect rates**. Noting what the placebo group did and comparing to the medications is also important.**
Weight loss PILLS on the other hand (supplements, anything on amazon or Instagram/Facebook ads) are a whole different story, and should be avoided (more on this later).
Obesity Medicine is a relatively new specialty with many medications in its toolkit. (ABOM).
Liraglutide (Victoza/Saxenda)
How it Works: Liraglutide is a GLP-1 medication that was created for Type 2 Diabetes. By acting on GLP-1 receptors, your body is tricked into producing more leptin/less ghrelin, and feeling full. These receptors also delay the rate your stomach empties, making you feel full longer after a meal.
The Lancet Trial showed that when compared to placebo, Liraglutide had 7.6% weight loss (placebo 2.3%) while Semaglutide had between 6-13.8% weight loss over 52 weeks. Everyone including placebo group in this study was asked to eat 500kcal below TDEE and was seen every 2 weeks for weeks 0-20 and every 4 weeks after until 52 weeks, and 150 min exercise/week was recommended.
SCALE Trial: 12 weeks, in Type 2 Diabetics: Liraglutide had 4.7-6.0% weight loss (placebo 2.0%) over 12 weeks. 500kcal deficit with 150min/week exercise.
Down Sides: The biggest side effect is nausea, vomiting, and GI distress reported between 17-38% depending on the dosage. Additionally, many, many insurances do not cover this medication for non-diabetics, and out of pocket it costs roughly $1000-$1200 per month. Victoza and Saxenda are injectables.
Scary: GLP-1 receptors are also in the Thyroid. There has been some evidence that both Liraglutide and Semaglutide can increase risk of a rare thyroid c-cell cancer. There's also evidence it increases risk of gallstones and pancreatitis.
Semaglutide (Ozempic/Wegovy/Rybelsus)
Same mechanism as Liraglutide, but reformulated as a more potent version, and higher reported weight loss. Again the same Down sides and Scary side effects as Liraglutide.
The STEP Trials were done to prove the efficacy of semaglutide for weight loss:STEP 3 showed that over 68 weeks, patients on 2.4mg Semaglutide lose 16.0% weight (5.7% Placebo). Impressively, 75% lost 10% or more, and 55% lost 15% or more over 68 weeks.
Of note: this study had the most intense placebo group I've ever seen. Take those high % with a grain of salt, given the exercise/diet regimen patients were on. For 8 weeks, everyone received Nutrisystem meal replacement at 1000-1200 cal/day. Then, patients transitioned to 1200-1800cal/day hypo-caloric diet for the remaining weeks. Everyone started on 100min exercise/week, increasing over 4 months by 25 min/week to 200min/week. They also had 30 individual dietician sessions over 68 weeks to walk through their diet and exercise.
Down Sides: See above
Scary: See above. This one is more expenseive ($1400/month sans insurance). You should be able to get coverage if you are T2 Diabetic, however.
Phentermine (Adipex, Lomira, Qsymia (combo with Topiramate))
How it works: Phentermine is a substituted amphetamine, meaning that in some ways it looks like an amphetamine but a far, far milder, less addictive, and safer version. It has way less "stimulant" effect and more appetite suppression. It primarily works by decreasing appetite, decreasing the caloric intake of patients and thus, making it easier to maintain a caloric deficit. It by itself does not cause weight loss, and increases in metabolism are minimal, if any. However, given its similarity, it is Schedule IV drug and cannot be taken concurrently with other stimulants/medications that could increase blood pressure.
The topic of whether phentermine increases blood pressure or is "bad for the heart" has been extensively discussed and the conclusion is no. While many people remember "fen-phen" in the 80s and 90s, the "fen" that caused heart valve side effects was fenfluramine (recalled in the 90s), which is no longer mixed with phentermine. Phentermine has actually shown to decrease blood pressure long term, given its impact on weight loss. It has no cardiovascular risk, in short or long term use. This is generally the most prescribed drug by obesity medicine providers, given it has been around since the 60s, is well-tolerated and generic (~$25/month)
Phentermine alone has shown upto 7.5% weight loss when used long term (24 months) in retrospective studies. When combined with Topiramate (either prescribed alone or as a combo med Qsymia) there are two large scale studies CONQUER and SEQUEL) patients lost between 9.3-10.5% (1.2% for placebo).
The placebo group in this study was given a LEARN manual on what foods to eat, seen every 4 weeks (including an extra visit at week 2 for dose adjustment), and instructed to reduce their caloric intake by 500kcal/day.
Down Sides: Most people have some degree of dry mouth with this medication (salivary gland activity decreased due to sympathetic nervous system activation). Insomnia and constipation are also common (~30%).
Scary: If you have a known history of substance use disorder, particularly with amphetamines, this medication is not for you. Given there is a theoretical risk of increased blood pressure, its not the first medication to prescribe for patients with history of arrhythmia.
Topiramate (Topamax, Qsymia)
How it works: See above for more information on Qsymia combination. Topiramate's mechanism for causing weight loss is similar to Phentermine in that it acts on GABA receptors to decrease appetite. In and of itself, it doesn't change your metabolism. It is a tool to make it easier to eat at a caloric deficit.
On Topiramate alone, patients lost approximately 3.9% within 3 months and 7.3% at 1 year, in patients taking the medication for epilepsy. Given its risk of kidney stones, very important to drink lots and lots of water on this medication!
Good news is, it is generic and pretty cheap (~$25/month, depending on your pharmacy/dosage)
Down Sides: Pins and needles tingling sensation (mostly in toes, sometimes other areas as well) (~30%), Taste changes (8-15% depending on dosage), fatigue. Not recommended as first medication for those with history of kidney stones, or epilepsy. Can't stop taking abruptly, as it can cause seizures.
Scary: Hair loss (alopecia) in about 1-4%. Memory change/confusion usually described as "brain fog"– not recommended for elderly, also rare.
Bupropion (Wellbutrin, Contrave (combo with Naltrexone))
How it works: Bupropion was developed as an antidepressant. Your brain naturally releases Norepinephrine and Dopamine to send signals shooting down your neurons. After a while, the hormones are taken back up to be released next time. This medication blocks re-uptake, allowing signaling to continue. Low levels of dopamine have been associated with increased hunger, so by increasing dopamine signaling, you will have less appetite/cravings. Again, this doesn't inherently increase metabolism, it just decreases appetite and improves mood for those who are struggling with both weight and depression. Good news is its also pretty cheap! (generic $~15/month)
In this trial of obese patients:placebo group lost 5%, bupropion group lost 7.2-10.1% over 24 weeks (based on dosage). Placebo group had an intro dietician visit and was provided a meal plan that recommended Slim Fast for 24 weeks, and 1 slim fast per day for the last 24 weeks (was not provided to patients, just recommended).
In this trial of obese patients with depression, patients lost 4.6% on bupropion vs 1.8% placebo (500kcal deficit) over 26 weeks. They also had <=50% depressive symptoms on medication.
Down Sides: Most common side effects reported between 11-17% are dry mouth, headache, nausea, insomnia (need to take in AM!) constipation, dizziness.
Scary: 0.4% of patients will have seizures on this medication at doses over 300XR, and rates increase with higher doses above this- this is still quite rare.
Naltrexone (Contrave, ReVia, Vitrol)
How it works: Naltrexone was originally created for substance use disorder, as it is an opioid receptor antagonist. However, it is now broadly used for other use disorders (tobacco, alcohol, binge eating disorder) as its been shown to decrease cravings overall in your brain's reward pathway. Its pretty cheap when prescribed alone as a generic, but Contrave combo is branded + expensive. You can get naltrexone/bupropion individually as generics for less.
There isn't much benefit when given alone, so its primarily prescribed with Bupropion (either as Contrave combo or both pills as generics).
Contrave: the combo of naltrexone/bupropion has been studied in a few trials to cause between 6.7-8.1% weight loss (1.8% placebo- mild hypocaloric diet and exercise), and in another trial 11.5% (7.3% placebo, with intense hypocaloric diet/exercise regimen).
Down Sides: Most commonly reported side effect is nausea (~30%) with headache, constipation in the ~10%
Scary: If you are concurrently using opioids, this will put you into withdrawal and can lead to opioid withdrawal symptoms. It should not be used in patients with seizure disorder due to a risk of increasing seizures.
Orlistat (Alli, Xenical)
How it works: Orlistat was made for weight loss: it directly works on your pancreatic lipase cells to literally block the breakdown and thus absorption of fats in your diet. Sounds like a miracle right? Unfortunately, it blocks ALL fats, and has multiple times/day dosing.
Blocking all fats means there is a risk of vitamin deficiencies when taken long term, or in those already deficient (vitamin D, E, A, K). It also means many patients struggle with the very common side effects of fats in their stool/flatulence, foul smelling gas, etc. Patients lost about 5.17% vs 2.75% with placebo.
Down Sides: Taken 120mg three times per day. Expensive, but over the counter (Alli) ~$150/month.
Scary: Due to its mechanism on fats, it can lead to increase risk of gallstones.
Metformin
How it works: Metformin is primarily used as a mainstay treatment for T2DM. It has been shown to help some patients lose weight as well, although mostly PCOS patients.Studies really vary on this,but most suggest modest weight loss of around 2.9kg vs 0.8kg placebo (minimal intervention). However, this weight loss is sustained long term, and the medication has other benefits on preventing progression of prediabetes -> diabetes, and controlling A1C.
Down Sides: Most patients complain of GI distress (nausea, vomitting, diarrhea, flatulence) ~20-40%.
Scary: Very rare, but some cases of lactic acidosis (kidney problem).
Plenity (cellulose and citric acid combo) aka Gelesis100
How it works: This is a new medication that actually went through something tricky with FDA-cleared vs FDA-approved. Because it was approved as a "medical device" rather than a prescription medication, its approval process was slightly different.
You know that feeling when you've eaten a large salad and your stomach feels full from the sheer volume of leafy greens you ate? That feeling is from cellulose in leafy greens that is indigestible, but makes you feel very full. That's what this is trying to mimic, its a cellulose/citric acid pill that expands with water in your stomach. You take this pill
There's really only 1 study that's been done on this, funded by Roman (you might know them as the ED company) the GLOW Trial which showed patients lost 6.4% vs 4.4% for placebo (a difference of only 2.2%) over 24 weeks. Its 3 2.25g capsules (big pills!) taken with 500mL water (2 cups of water) 20-30 minutes before dinner. These pills expand with water and make you feel full at meal times so you eat less.
Down Sides: Poor evidence it really works, about $100/month. Given that just 500ml water at meal times has been shown to decrease caloric consumption by almost 200kcal/day and the same weight reduction, doesn't really have good data to support the medication!
Scary: Do not take this if you have had vertical sleeve gastrectomy, or at least talk to your PCP first! You have a smaller stomach after surgery, and the expanding gel pills could cause perforation/expansion.
Summary Table:
​

Medication	% weight loss - % placebo	Oral/Injectable/Dosing	Price for 1 month
Liraglutide	5.3%, SCALE 2.7-4%	Oral and Injectable	$1000, covered for T2DM and sometimes pre-diabetics
Semaglutide	STEP 3: 10.3%	Oral and Injectable	$1200-$1400, covered for T2DM and some prediabetics
Phentermine	7.5% alone, 8.1-9.3% with Topiramate	Oral, AM	$25 (Qsymia is $200)
Topiramate	7.3% alone, 8.1-9.3% with Phentermine	Oral, PM	$25 (Qsymia is $200)
Bupropion	2.2-5.1% alone, 4.8-6.3% with Naltrexone	Oral, AM	~$15 (Contrave is $200-$400)
Naltrexone	4.8-6.3% with Bupropion	Oral, AM	~$15 (Contrave is $200-$400)
Orlistat	2.42%	Oral, 3x/day	~$150
Metformin	~5lbs	Oral	$25
Plenity	2.2%	Oral, 3x/day	$100

​
NOW, the other topic: Weight loss Supplements.
Phen-Q: Primarily a caffeine pill, with B3 and capsicum. No clinical studies showing it helps lose weight.
Waist Trainers: Make your stomach sweat. They're marketted as a way to make your stomach lose water weight/slim. However, there's no evidence they do that, and they actually decrease your lung function.
FitTeas/laxative tea: These are usually Senna based teas, a common herb-based laxative. Not only are they overpriced, but chronic senna use leads to melanosis coli! Also scary, chronic use can lead to cyclic edema– ie. this case.
B12/Lipotropic shots: No evidence it helps with weight loss unless you have a clinical lab finding showing deficiency. Even then, oral therapy is usually enough. For patients who have had gastric bypass, deficiency is common and should be checked on labs BEFORE starting therapy.

Controversial topic incoming! New MD ('22) here! I know that many people who are looking to lose weight would prefer a natural option without medication. But, prescription weight loss medication from a provider you have an established relationship with IN CONJUNCTION with lifestyle changes has a higher likelihood of producing sustainable results (AACE Guidelines). Taking any medication is a very personal decision, so please take this with a grain of salt and talk to a provider you trust. Also of note, many doctors are not comfortable prescribing medication for weight due to long standing stigma. For those looking, happy to help you vet an in-person or weight loss provider with the appropriate credentials. This is just a passion project of mine, and something I've personally struggled with.
For each of these, I'll walk through a brief overview of the mechanism, landmark trials showing evidence it works and in what population, and side effects/side effect rates. Noting what the placebo group did and comparing to the medications is also important.
Weight loss PILLS on the other hand (supplements, anything on amazon or Instagram/Facebook ads) are a whole different story, and should be avoided (more on this later).
Obesity Medicine is a relatively new specialty with many medications in its toolkit. (ABOM).
Liraglutide (Victoza/Saxenda)
How it Works: Liraglutide is a GLP-1 medication that was created for Type 2 Diabetes. By acting on GLP-1 receptors, your body is tricked into producing more leptin/less ghrelin, and feeling full. These receptors also delay the rate your stomach empties, making you feel full longer after a meal.
The Lancet Trial showed that when compared to placebo, Liraglutide had 7.6% weight loss (placebo 2.3%) while Semaglutide had between 6-13.8% weight loss over 52 weeks. Everyone including placebo group in this study was asked to eat 500kcal below TDEE and was seen every 2 weeks for weeks 0-20 and every 4 weeks after until 52 weeks, and 150 min exercise/week was recommended.
SCALE Trial: 12 weeks, in Type 2 Diabetics: Liraglutide had 4.7-6.0% weight loss (placebo 2.0%) over 12 weeks. 500kcal deficit with 150min/week exercise.
Down Sides: The biggest side effect is nausea, vomiting, and GI distress reported between 17-38% depending on the dosage. Additionally, many, many insurances do not cover this medication for non-diabetics, and out of pocket it costs roughly $1000-$1200 per month. Victoza and Saxenda are injectables.
Scary: GLP-1 receptors are also in the Thyroid. There has been some evidence that both Liraglutide and Semaglutide can increase risk of a rare thyroid c-cell cancer. There's also evidence it increases risk of gallstones and pancreatitis.
Semaglutide (Ozempic/Wegovy/Rybelsus)
Same mechanism as Liraglutide, but reformulated as a more potent version, and higher reported weight loss. Again the same Down sides and Scary side effects as Liraglutide.
The STEP Trials were done to prove the efficacy of semaglutide for weight loss:STEP 3 showed that over 68 weeks, patients on 2.4mg Semaglutide lose 16.0% weight (5.7% Placebo). Impressively, 75% lost 10% or more, and 55% lost 15% or more over 68 weeks.
Of note: this study had the most intense placebo group I've ever seen. Take those high % with a grain of salt, given the exercise/diet regimen patients were on. For 8 weeks, everyone received Nutrisystem meal replacement at 1000-1200 cal/day. Then, patients transitioned to 1200-1800cal/day hypo-caloric diet for the remaining weeks. Everyone started on 100min exercise/week, increasing over 4 months by 25 min/week to 200min/week. They also had 30 individual dietician sessions over 68 weeks to walk through their diet and exercise.
Down Sides: See above
Scary: See above. This one is more expenseive ($1400/month sans insurance). You should be able to get coverage if you are T2 Diabetic, however.
Phentermine (Adipex, Lomira, Qsymia (combo with Topiramate))
How it works: Phentermine is a substituted amphetamine, meaning that in some ways it looks like an amphetamine but a far, far milder, less addictive, and safer version. It has way less "stimulant" effect and more appetite suppression. It primarily works by decreasing appetite, decreasing the caloric intake of patients and thus, making it easier to maintain a caloric deficit. It by itself does not cause weight loss, and increases in metabolism are minimal, if any. However, given its similarity, it is Schedule IV drug and cannot be taken concurrently with other stimulants/medications that could increase blood pressure.
The topic of whether phentermine increases blood pressure or is "bad for the heart" has been extensively discussed and the conclusion is no. While many people remember "fen-phen" in the 80s and 90s, the "fen" that caused heart valve side effects was fenfluramine (recalled in the 90s), which is no longer mixed with phentermine. Phentermine has actually shown to decrease blood pressure long term, given its impact on weight loss. It has no cardiovascular risk, in short or long term use. This is generally the most prescribed drug by obesity medicine providers, given it has been around since the 60s, is well-tolerated and generic (~$25/month)
Phentermine alone has shown upto 7.5% weight loss when used long term (24 months) in retrospective studies. When combined with Topiramate (either prescribed alone or as a combo med Qsymia) there are two large scale studies CONQUER and SEQUEL) patients lost between 9.3-10.5% (1.2% for placebo).
The placebo group in this study was given a LEARN manual on what foods to eat, seen every 4 weeks (including an extra visit at week 2 for dose adjustment), and instructed to reduce their caloric intake by 500kcal/day.
Down Sides: Most people have some degree of dry mouth with this medication (salivary gland activity decreased due to sympathetic nervous system activation). Insomnia and constipation are also common (~30%).
Scary: If you have a known history of substance use disorder, particularly with amphetamines, this medication is not for you. Given there is a theoretical risk of increased blood pressure, its not the first medication to prescribe for patients with history of arrhythmia.
Topiramate (Topamax, Qsymia)
How it works: See above for more information on Qsymia combination. Topiramate's mechanism for causing weight loss is similar to Phentermine in that it acts on GABA receptors to decrease appetite. In and of itself, it doesn't change your metabolism. It is a tool to make it easier to eat at a caloric deficit.
On Topiramate alone, patients lost approximately 3.9% within 3 months and 7.3% at 1 year, in patients taking the medication for epilepsy. Given its risk of kidney stones, very important to drink lots and lots of water on this medication!
Good news is, it is generic and pretty cheap (~$25/month, depending on your pharmacy/dosage)
Down Sides: Pins and needles tingling sensation (mostly in toes, sometimes other areas as well) (~30%), Taste changes (8-15% depending on dosage), fatigue. Not recommended as first medication for those with history of kidney stones, or epilepsy. Can't stop taking abruptly, as it can cause seizures.
Scary: Hair loss (alopecia) in about 1-4%. Memory change/confusion usually described as "brain fog"– not recommended for elderly, also rare.
Bupropion (Wellbutrin, Contrave (combo with Naltrexone))
How it works: Bupropion was developed as an antidepressant. Your brain naturally releases Norepinephrine and Dopamine to send signals shooting down your neurons. After a while, the hormones are taken back up to be released next time. This medication blocks re-uptake, allowing signaling to continue. Low levels of dopamine have been associated with increased hunger, so by increasing dopamine signaling, you will have less appetite/cravings. Again, this doesn't inherently increase metabolism, it just decreases appetite and improves mood for those who are struggling with both weight and depression. Good news is its also pretty cheap! (generic $~15/month)
In this trial of obese patients:placebo group lost 5%, bupropion group lost 7.2-10.1% over 24 weeks (based on dosage). Placebo group had an intro dietician visit and was provided a meal plan that recommended Slim Fast for 24 weeks, and 1 slim fast per day for the last 24 weeks (was not provided to patients, just recommended).
In this trial of obese patients with depression, patients lost 4.6% on bupropion vs 1.8% placebo (500kcal deficit) over 26 weeks. They also had <=50% depressive symptoms on medication.
Down Sides: Most common side effects reported between 11-17% are dry mouth, headache, nausea, insomnia (need to take in AM!) constipation, dizziness.
Scary: 0.4% of patients will have seizures on this medication at doses over 300XR, and rates increase with higher doses above this- this is still quite rare.
Naltrexone (Contrave, ReVia, Vitrol)
How it works: Naltrexone was originally created for substance use disorder, as it is an opioid receptor antagonist. However, it is now broadly used for other use disorders (tobacco, alcohol, binge eating disorder) as its been shown to decrease cravings overall in your brain's reward pathway. Its pretty cheap when prescribed alone as a generic, but Contrave combo is branded + expensive. You can get naltrexone/bupropion individually as generics for less.
There isn't much benefit when given alone, so its primarily prescribed with Bupropion (either as Contrave combo or both pills as generics).
Contrave: the combo of naltrexone/bupropion has been studied in a few trials to cause between 6.7-8.1% weight loss (1.8% placebo- mild hypocaloric diet and exercise), and in another trial 11.5% (7.3% placebo, with intense hypocaloric diet/exercise regimen).
Down Sides: Most commonly reported side effect is nausea (~30%) with headache, constipation in the ~10%
Scary: If you are concurrently using opioids, this will put you into withdrawal and can lead to opioid withdrawal symptoms. It should not be used in patients with seizure disorder due to a risk of increasing seizures.
Orlistat (Alli, Xenical)
How it works: Orlistat was made for weight loss: it directly works on your pancreatic lipase cells to literally block the breakdown and thus absorption of fats in your diet. Sounds like a miracle right? Unfortunately, it blocks ALL fats, and has multiple times/day dosing.
Blocking all fats means there is a risk of vitamin deficiencies when taken long term, or in those already deficient (vitamin D, E, A, K). It also means many patients struggle with the very common side effects of fats in their stool/flatulence, foul smelling gas, etc. Patients lost about 5.17% vs 2.75% with placebo.
Down Sides: Taken 120mg three times per day. Expensive, but over the counter (Alli) ~$150/month.
Scary: Due to its mechanism on fats, it can lead to increase risk of gallstones.
Metformin
How it works: Metformin is primarily used as a mainstay treatment for T2DM. It has been shown to help some patients lose weight as well, although mostly PCOS patients.Studies really vary on this,but most suggest modest weight loss of around 2.9kg vs 0.8kg placebo (minimal intervention). However, this weight loss is sustained long term, and the medication has other benefits on preventing progression of prediabetes -> diabetes, and controlling A1C.
Down Sides: Most patients complain of GI distress (nausea, vomitting, diarrhea, flatulence) ~20-40%.
Scary: Very rare, but some cases of lactic acidosis (kidney problem).
Plenity (cellulose and citric acid combo) aka Gelesis100
How it works: This is a new medication that actually went through something tricky with FDA-cleared vs FDA-approved. Because it was approved as a "medical device" rather than a prescription medication, its approval process was slightly different.
You know that feeling when you've eaten a large salad and your stomach feels full from the sheer volume of leafy greens you ate? That feeling is from cellulose in leafy greens that is indigestible, but makes you feel very full. That's what this is trying to mimic, its a cellulose/citric acid pill that expands with water in your stomach. You take this pill
There's really only 1 study that's been done on this, funded by Roman (you might know them as the ED company) the GLOW Trial which showed patients lost 6.4% vs 4.4% for placebo (a difference of only 2.2%) over 24 weeks. Its 3 2.25g capsules (big pills!) taken with 500mL water (2 cups of water) 20-30 minutes before dinner. These pills expand with water and make you feel full at meal times so you eat less.
Down Sides: Poor evidence it really works, about $100/month. Given that just 500ml water at meal times has been shown to decrease caloric consumption by almost 200kcal/day and the same weight reduction, doesn't really have good data to support the medication!
Scary: Do not take this if you have had vertical sleeve gastrectomy, or at least talk to your PCP first! You have a smaller stomach after surgery, and the expanding gel pills could cause perforation/expansion.
Summary Table:

Medication	% weight loss - % placebo	Oral/Injectable/Dosing	Price for 1 month
Liraglutide	5.3%, SCALE 2.7-4%	Oral and Injectable	$1000, covered for T2DM and sometimes pre-diabetics
Semaglutide	STEP 3: 10.3%	Oral and Injectable	$1200-$1400, covered for T2DM and some prediabetics
Phentermine	7.5% alone, 8.1-9.3% with Topiramate	Oral, AM	$25 (Qsymia is $200)
Topiramate	7.3% alone, 8.1-9.3% with Phentermine	Oral, PM	~$25 (Qsymia is $200)
Bupropion	2.2-5.1% alone, 4.8-6.3% with Naltrexone	Oral, AM	~$15 (Contrave is $200-$400)
Naltrexone	4.8-6.3% with Bupropion	Oral, AM	~$15 (Contrave is $200-$400)
Orlistat	2.42%	Oral, 3x/day	~$150
Metformin	~5lbs	Oral	$25
Plenity	2.2%	Oral, 3x/day	$100

NOW, the other topic: Weight loss Supplements.
Phen-Q: Primarily a caffeine pill, with B3 and capsicum. No clinical studies showing it helps lose weight.
Waist Trainers: Make your stomach sweat. They're marketted as a way to make your stomach lose water weight/slim. However, there's no evidence they do that, and they actually decrease your lung function.
FitTeas/laxative tea: These are usually Senna based teas, a common herb-based laxative. Not only are they overpriced, but chronic senna use leads to melanosis coli! Also scary, chronic use can lead to cyclic edema– ie. this case.
B12/Lipotropic shots: No evidence it helps with weight loss unless you have a clinical lab finding showing deficiency. Even then, oral therapy is usually enough. For patients who have had gastric bypass, deficiency is common and should be checked on labs BEFORE starting therapy.

I just wanted to warn everyone that this a possibility. I wouldn’t wish psychosis on my worst enemy, so I feel compelled to talk about this experience. Articles about modafinil and psychosis have been posted here before, but the comments usually explain away the unlikelihood of triggering psychosis for various reasons.
Yes, psychosis can be caused by almost any drug, it is more likely when it’s misused, it usually only happens to people with an underlying disposition, etc. I get that. It’s so easy to write off the findings of a published article or case study as not applicable to you personally. Nonetheless, I hope that my experience can be valuable to someone and emphasize psychosis as a real possibility.
Being psychotic was living out an inescapable series of the scariest experiences of my life back to back to back to back. I was trapped in a bad acid trip for days on end, I scared and hurt the people that care about me. Luckily I’m doing better now, because some people never fully recover.
I’m still working with professionals to try and figure out what exactly triggered the break. I have a hunch the cause was the modafinil itself and side effects like sleep deprivation. Stimulants are risky because psychosis is clearly linked to dopamine and they can cause a break without warning or misuse. I have a history of stimulant therapeutic use and some abuse (all nighters on adderall, compulsively redosing ritalin, Phentermine, cocaine, etc.). I never showed psychotic symptoms of any level of severity before this episode. I was even clued in enough to identify “coke ideas” or drug fueled plans/telling stories/feelings that will never come to fruition when people sober up.
When the episode was most severe (it’s hard to tell when exactly things started), I was also taking lexapro, 300mg gabapentin as needed. I would substitute moda for my usual methylphenidate a few days a week. I might be misdiagnosed, but as of now my med chart says adhd and postpartum depression/mood disturbance. Also, the episode ended gradually as I quit taking any drugs.
Let me know if you have any questions.
My experience is rare, but pay vigilant attention to any changes in your thoughts and behaviors. You can see patterns and changes by journaling your moods and stuff. I can retrospectively see signs of instability that could have been brought up to my psych earlier and prevented a lot of suffering.
Edit: I really appreciate everyone’s concerns and insight. I don’t want to seem like a jerk, but: Yes, I’m sure it was really psychosis. I’m using the term psychosis as it is defined in the DSM. It was textbook full blown psychosis.

I am doing research on apetite supressants for weight management and in one paper they mention the drug Phentermine to be used as a drug for treating obesity ¹. When looking into the clinical data of Phentermine, wikipedia states that another name for it is "α-methylamphetamine". It also states that chemically, phentermine is a substituted amphetamine.
I went over to the page that explains what subsituted amphetamines are and there I found methamphetamine to be among the list of derivative compounds. Methamphetamine elsewere is named as "N-methylamphetamine".
Now I am wondering:

1. What is the big difference between these two compounds and how can something so close to methamphetamine be prescribed for obesity? (Knowing its potential for abuse)
2. How does the addition of a -methyl group to the amphetmine molecule affect its functionality compared to something like dextroamphetamine (D-amphetamine)?

​
¹ Hendricks E. J. (2017). Off-label drugs for weight management. Diabetes, metabolic syndrome and obesity : targets and therapy, 10, 223–234. doi:10.2147/DMSO.S95299

I used to be scared of the shadow people, but a good healthy habit of amphetamine abuse taught me that they're friends.
I know you guys are into shadow people around here but something tells me that only "spiritual" type drugs would get you the real thing right?
I overdosed on phentermine last night, a substituted amphetamine and therefore likely to cause stimulant psychosis. Honestly until the part where I threw up and realized that my heart could have been endangered, I was having a blast to be honest. It seemed like every small object and every shadow and every lightprint on my eye had their own personality and were all bickering amongst eachother, and occasionally I would offhandedly reply to one (in my head). Now I realized that wasn't exactly normal for an amphetamine high, but I didn't feel as though I were endangered so I just rolled with it. After I talked with poison control, took my heartrate (150bpm), and calmed down a bit I decided to enjoy my 'psychosis' a bit and visit my shadow buddies. Very strange being close to "clear-headed" but still having intense interactive visuals -- it was like the effects of not sleeping for 5-7 days except I just hadn't gone to bed that night. So I popped in and got acquainted with a couple of shadow individuals in my closet, and it was fascinating how responsive they seemed and able to impart a sort of response when I questioned them.
Now I don't actually believe in spirits and I don't believe that I spoke with any entities, obviously all just a drug induced fiasco. But I want to hear what you guys think about this? Because DMT/LSD experiences aren't at all like stimulant psychosis, it takes time to almost form a relationship with the shadow people in meth land. Being comfortable in their 'presence' is an interesting phenomenon
Sorry about how incoherent and profoundly disturbing this post may be to some of you. It's been about 20 hours or so since the overdose and I'm still a bit confused, but I just got bored and went to visit the shadow buddies since I couldn't sleep and its gone now. Just smaller annoying hallucinations. I just thought this would be interesting for you guys because I know if I believed in the occult I'd certainly convince myself there was something more to this than drugs.
Drugs or not, occult or not, I think we can all agree that shadow peeps are fascinating entities right folks?

I've been struggling to lose weight for the past several years. I'll start with a little history about my journey, and how my process went for getting the Phentermine prescription. If you don't care about that just skip ahead a few paragraphs to where I talk about the drug itself, I'll forgive you. I also want to hear others (your) experiences, good or bad, as I've seen wildly different accounts in other places. Did you have crazy side effects? How long were you on it? Did you gain the weight back after getting off? What was the attitude of your Physician?
In case you're unfamiliar with Phentermine, it's an appetite suppressant based on a substituted amphetamine structure and is prescribed as a treatment for obesity to be used in conjunction with a healthy diet and exercise. Possible side effects (copied from the Wikipedia link) include: Xerostomia (dry mouth), Restlessness, Nervousness, Euphoria, Agitation, Arrhythmia, Tachycardia, Hypertension, Diarrhea, Vomiting, Headache, Rash, Urinary frequency, Facial oedema, Unpleasant taste, Urticaria, Impotence, Changes in libido, and Aortic regurgitation.
My story. I'll do very well with diet and exercise for a few months, get discouraged, and then pop back up close to my SW before trying again. When I'm on point, I use MFP and weigh all of my portions and normally can come in under or very close to my daily calories. I've been through several fitness bands, from Jawbone Up, to Fitbit Charge HR which recently broke, so I just purchased a Garmin Vivosmart HR+ and I'll normally blast through 10k steps most days. I've started C25K several times only to get horrible shin splints around week 5 or 6 each time and have to stop because it hurts to even walk. This is where I'll usually stop, thinking I'll get back to running when the pain subsides, but then a few months later I'm cursing at myself for not sticking with things and try again. Rinse. Repeat.
I started doing keto back in February after learning about the subreddit /keto here, and dropped a quick 25ish without doing much else and have more or less plateaued since May.
A few weeks ago, I went to see the doctor for my annual physical and asked about possible weight loss solutions thinking I may get referred to a nutritionist, and she mentioned 2 options: Bariatric surgery, which she really seemed to recommend, and Phentermine, which she seemed hesitant to endorse, although she has seen some limited success in other patients. After talking through the options at length with her, I told her I'd really only consider the surgery as a LAST resort, and she agreed to try the Phentermine as long as my blood work came back fine (no high blood pressure/diabetes/pre-diabetes, etc.), and I was willing to exercise, eat properly, and make the correct long-term lifestyle changes. So I showed her my MFP, Fitbit, and Withings scale histories and I think she was convinced I was trying.
Other than my weight, I'm in otherwise decent health. BP has been ~125/80 give or take a couple depending, Cholesterol was 172 with HDL/LDL/Triglycerides in good ranges, and the other blood work was good.
This past Friday I went back for a follow-up with her, and we agreed to try Phentermine on a 12 week trial, with the first month starting at 15mg/day and bumping up to 30mg/day thereafter as long as I'm tolerating the 15mg after the first month.
I started my first dose on Saturday morning. After 4 days, I think I'm going to really like it. I haven't really felt hungry at all during the day, and I've had to remember to make myself eat lunch and dinner as my doctor specifically said to not skip meals. I think it's taking me a bit longer to sleep than I normally would, and I feel like I'm waking up to turn over more often than before, but I haven't had insomnia and I don't feel tired. I don't really have dry mouth, but I find myself drinking a lot more fluids during the day than I used to. I feel a bit more zippy than normal too but not wired. That first day I logged over 25,000 steps walking around town (Pokemon Go).
The best part though is I no longer feel hungry. Is it food addiction? I don't know, but feeling hungry in many ways feels like when I finally quit smoking cold-turkey many years ago. You always want to smoke, and if you can battle through that for a couple of weeks the cravings eventually went away for me. But for food, it's never subsided for me.
Before, throughout the day, I kept finding myself in the kitchen mentally battling myself to not eat anything because I always felt hungry. I was always hungry. Always. An hour after eating a big meal, I'd find myself staring into the refrigerator yelling at myself in my head to shut the door and go sit down and drink a glass of water instead. When I'd start a diet before, I'd lose weight because I would just put up with being hungry with only a few brief respites when I'd eat my healthy meals.
All of that is gone now. I don't have that constant, nagging, pang and the mental battles of will that often times I'd seem too weak to win. I hope then it's time to get off the pills and I've lost the weight, that those feelings of constant, nagging hunger don't come back because right now I feel free!

Some background on myself: I am 28 years old, 240 lbs and super upset about my physical condition. I am perhaps the least healthy now than I have ever been. I was overweight throughout my childhood and teens and through college, I was always on and off “eating healthy.” Generally speaking I’ve always had a contentious relationship with food—although it was nothing as bad as what it is now. My final year of college (2009), I began regularly visiting a bariatric specialist. The doctor ran all sorts of tests and labs and put me on a diet plan with meal substitutes, a truck load of vitamins and phentermine and zonisamide (diet drugs that work). Their methodology was that obesity is a disease just as much as heart disease and that it needed to be treated with medication and behavior modification. I ran regularly maybe 4 miles 3 times a week and increased my walking. The diet was really hard. I ate maybe 700 cal a day 100 grams of protein and no solid food except pickles and SF jello (which isn’t really solid). I was losing 5-10 lbs a week. And going to the clinic every week at $100-$200 a visit. But it worked, I went from 190 to 155 in three months. I ran a ton, it was so easy and I could workout in skimpy clothes. I loved it. I couldn’t eat basically anything but other parts of my life were great. I lost another 20 lbs over 6 months when the doctor slowly introduced actual food but I could still some days have a calorie deficit that was probably dangerous. (Eat 900 cal, workout 1000 cal and 1400 BMR) I lived in a city with few friends so the social aspect of the diet was not a problem. Then I moved home after graduation and I met new friends and started eating out. It wasn’t that problematic because I started weight training and was still on the drugs, so I wasn’t crazy out of control. I worked in a natural grocery store (t is a proven phenomena seen in persons who were on a severely restricted diet—to work in the food service industry) and fantasied about opening my own bakery despite having just earned a Master of Architecture degree. Things went okay until, my depression became out of control and my psychiatrist put me on Risperidone for my suicidality. Thankfully I had only one side effect, which was weight gain of about 10 per month for almost a year. So long went my self-confidence, and I became depressed about weight again. I moved away (running away from problems) to a city where my bariatric doctor had no office. I tried to recreate my diet from the clinic but failed. I began traveling 6 hrs a week at night and ate sugar to stay alert. I began binge eating weekly, then daily. I am now off the risperidone but needed to be put on mirtazapine for basically the same purpose. I recently lost some weight on a keto diet, (270 lbs to 220) but then gained back 20. I have used MFP to track foods, but my girlfriend and I (also F, not to be confusing) eat out regularly and I always stumble then fall of the wagon of food tracking. I read a book called Thin Side Out http://www.josiespinardi.com/shop.html which attempts to quell binging with moderation via hunger-directed eating, but I couldn’t really adapt to this. I don’t work out very often due to the mental stumbling block of my current weight, though I try to be as active as possible in my daily life. I constantly think about my weight. Maybe every waking minute, it depresses me. I know that stats on long-term weight loss are abysmal. I am one of those stats as of now. I have lost weight but every time have gained it back. I am not unmotivated. But I feel like a bad person. People tell me to try harder, but I literally don’t know how. I am not stupid, but I can’t figure this out. I don’t know what to do. I really could use some support, of any kind. Thank you
TLDR:I feel like I’ve tried everything but weigh more now than ever. I don’t know what to do and am hopeless. What has been the way you have gotten over this experience? I feel like you must understand my struggle more than my friends and family. Please help.