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Weight loss medication?

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Hi everyone -

I'm almost a year out from my surgery. I'm down 150 pounds and still losing, although quite a bit slower than before. I had a pretty high starting weight though and I'm still obese. My Endo is a big fan of maximum results and has offered me a combination of topiramate and phentermine to keep me going. It comes as a combo drug but i'd be taking it separately to save money. 

Phentermine got such a bad rap years ago with the whole Fen-Phen thing. I don't even remember the details as I wasn't that old, but I remember it being all over the news. About 5 years ago I talked to my old doc in my hometown about possibly starting MediFast and about halfway through the appointment she stated she WOULD NOT prescribe any medication - even though I hadn't asked for any (MediFast is just a mail-order diet, if you haven't heard of it). But, this wouldn't be the first time my current healthcare was able to do something for me that I never could get back in my hometown. 

I have a *crazy* advantage in that I work and get my healthcare at a highly ranked medical facility. I even work in Endocrinology and my doc literally is like 50 feet away from me every day. I'm a medical secretary and I'm surrounded by medical providers. I've had nothing short of amazing care there and if something did go wrong, I'd be well taken care of. But I'm still a little nervous about it for some reason, so wondering if anyone else has taken this and if yes what has the experience been? 

There's also another doc currently running a study with another medication, and he said if I had side effects from this combo, that I might be able to enter the study, but he didn't tell me which medication that would be. If you've taken other prescription weight loss medication, I'm interested in that story too. 

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Fen-phen was pulled from the market for causing pulmonary hypertension and other heart disorders, including valvular heart failure. 

Its been repackaged and remarketed now as Qsymia. I'd have a long discussion with your endocrine doc about it and ensure that youll be closely monitored while on it. 

The only medication Ive tried was Saxenda, which is the weight loss marketed brand of a medication that is normally for diabetics, but they noticed weight loss occurring in trials. It made you feel bloaty and full, so you ate less. Downside? Heartburn for dayyyys. And it was injectable, not a pill. 

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I was on Phentermine, twice. It worked great, but your body builds up a tolerance to it fairly quickly. The Dr I was seeing that prescribed it to me, also had me on some other supplements to try to diminish the tolerance of the phentermine.  In my case I think I started noticing the reduced effects in about 10 or 12 weeks.  But maybe that's what the 2nd medication is for that your Dr would prescribe?

I wouldn't tell you to do it or not do it. In my case, it was one of the best times of my life, spoken from the viewpoint of a recovering fat person. Phentermine simply let me not think about food, ever. It was much like my current situation- I had to remember to eat, because my body needed fuel. My Dr insisted that I follow a pretty low carb diet to bolster the weight loss effects.

I suppose if you have a Dr that knows the drug very well and will be monitoring you closely, it wouldn't be a bad thing. But that's just my free take on the matter....   :-)

 

Edited to add:  Note that there is a difference between "fen-phen", the banned combination drug, and straight phentermine, which is still approved by the FDA today for short-term weight loss.

Edited by Michael_A

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I was on Fen Phen back in the mid 90s. I lost my excess weight with it and even kept it off for about 5 years. No problems at all from taking it.

I recently took phentermine and ionomin. I lost about 50 pounds using it. The trouble for me has been with all of these meds was that as soon as I quit taking it, the weight came back plus some. That should not happen in your case since you have had the surgery.

My vote is to go ahead and give it a try. If your appetite is out of control it should help immensely. Especially since you have not yet tried any of these meds. I will agree with Michael though. Take as much advantage as possible of it in the beginning. People do tend to build a tolerance and it loses it's affect rather quickly for most.

 

Good luck!

Edited by Readytobeme

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4 hours ago, delilas said:

Fen-phen was pulled from the market for causing pulmonary hypertension and other heart disorders, including valvular heart failure. 

Its been repackaged and remarketed now as Qsymia. I'd have a long discussion with your endocrine doc about it and ensure that youll be closely monitored while on it. 

The only medication Ive tried was Saxenda, which is the weight loss marketed brand of a medication that is normally for diabetics, but they noticed weight loss occurring in trials. It made you feel bloaty and full, so you ate less. Downside? Heartburn for dayyyys. And it was injectable, not a pill. 

I think the "fen" part of fen-phen is what was banned. phentermine is a stimulant though so I won't be taking it lightly. i think more than anything it's just this idea that's been placed in my head that weight loss medication is "bad." My Endo seemed more concerned about the possible side effects from the topiramate than from the phentermine, but we had a long talk about them on Friday. I'd be tapering and watching for the side effects and then I'll add the phentermine in after that's done if all goes well. 

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I would not suggest that you take any weight loss drugs.  Quite simply, there is no reason that you cannot reach your current goal weight (and perhaps even lower) with your gastric bypass by just sticking to the proper post-op diet, drinking lots of liquids, and leading an active lifestyle.  Even if you are only losing an average of 8 pounds a month, that still works out to be about 100 pounds a year.  Remember that your current weight loss surgery journey is not simply a diet to lose weight - instead it is a lifelong endeavor to become and remain thin and healthy.  So what really matters is not how fast you reach your goal weight but whether you can remain at your goal weight for the rest of your life.

If you are having an appetite problem, then try drinking liquids or consuming some lean protein when you feel hungry.  For example, if you drink half a container of a Premier Protein shake (the chocolate flavor is quite tasty), it is highly unlikely that you will still feel hungry.  And make sure that your hunger is not "head hunger" - which will not be helped by any weight loss drug - rather than body hunger.

Finally, great job so far with your weight loss. :) 

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On 12/3/2017 at 10:52 AM, delilas said:

Fen-phen was pulled from the market for causing pulmonary hypertension and other heart disorders, including valvular heart failure. 

Its been repackaged and remarketed now as Qsymia. I'd have a long discussion with your endocrine doc about it and ensure that youll be closely monitored while on it. 

The only medication Ive tried was Saxenda, which is the weight loss marketed brand of a medication that is normally for diabetics, but they noticed weight loss occurring in trials. It made you feel bloaty and full, so you ate less. Downside? Heartburn for dayyyys. And it was injectable, not a pill. 

@delilas Is Saxenda the same as Vixtoza? If it is, that med is a doozy. The first three weeks I injected Victoza, I felt that my insides were on fire. My endo told me I would lose weight but no dice. 

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12 hours ago, NerdyLady said:

@delilas Is Saxenda the same as Vixtoza? If it is, that med is a doozy. The first three weeks I injected Victoza, I felt that my insides were on fire. My endo told me I would lose weight but no dice. 

Yup! Saxenda is dosed higher than Victoza, but they're otherwise the same. I felt so bloated on it I couldn't eat but couldn't drink either. Tried it for about a month and then pitched it. Ugh. I have had patients do really well on Victoza, but it was definitely not for me!

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I would echo the advice from @Res Ipsa as most people who use phentermine gain back their weight and then some, much like those who try "diets".  I personally was on it more than once in my decades of trying everything.  I absolutely loved phentermine because I felt normal on it and wasn't consumed with the thought of feeding myself every waking hour.  Unfortunately I had horrible headaches on it, and I gained back every single pound once stopping it.  The last thing you need right now is another "failure", when you already have in place the best tool for long term success.

You are doing so great!!! Wow, 150 pounds down is so amazing; you must be feeling pretty good about that!  Whatever you decide to do, I wish you continued success!

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I agree with @msmarymac and @Res Ipsa. You've lost 150 pounds in a year! That is fantastic! Stick with your eating plan, up your water and get more exercise. I expect you'll be at goal by this summer.

 

To answer your question I've taken phentermine a couple of times. For me, it is like speed. I cannot sleep and I cannot sit still. I have no appetite but I'm grouchy and extra short tempered. I do not recommend it. 

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