Research
Hormonal
Phentermine-Topiramate produces moderate weight loss (7.87-8.45%) and improves cardiometabolic risk factors, but carries higher risks of neuropsychiatric and cardiovascular side effects compared to GLP-1RAs.
Phentermine-Topiramate is an oral medication that produces moderate weight loss (approx 8%). It is less effective than GLP-1RAs and carries higher risks of side effects like anxiety, paresthesia, and cardiovascular issues. It is not recommended for patients with existing heart disease.
GoodQualifiesHIGH confidence
After 52-56 weeks, the mean percentage loss was 8.45% (95% CI, 7.89%–9.01%)... The CONQUER trial did reveal a dose-dependent increase in neuropsychiatric effects, including cognitive changes, attention difficulties, depression, and anxiety.
Why this rating
Supported by meta-analyses and clinical approval trials.
Source
Comparison of GLP-1RAs vs Other Pharmacotherapy for Obesity
Andrew Overholser et al. · Translation The University of Toledo Journal of Medical Sciences · 2025
DOI 10.46570/utjms-2024-1218
narrative_reviewCited 1×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Tirzepatide (a dual GLP-1RA/GIP agonist) produces superior mean weight loss (18.4%) compared to other FDA-approved pharmacotherapies for obesity, including semaglutide, phentermine-topiramate, and orlistat.Good
- Semaglutide (a GLP-1RA) produces significant weight loss (10-12.5%) and improves cardiometabolic risk factors, making it more effective than older pharmacotherapies like Phentermine-Topiramate and Orlistat.Good
- Orlistat produces minimal weight loss (2.78-3.16%) and has a high gastrointestinal side effect profile, making it a less effective first-line treatment compared to GLP-1RAs.Good
Related findings · Hormonal
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- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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