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Phentermine-topiramate combinations (Qsymia) carry more substantial concerns, as topiramate can reduce contraceptive steroid levels through enzyme induction, potentially increasing breakthrough bleeding and reducing efficacy, particularly at higher doses

For example, 58% of patients stopped treatment before reaching a 5% reduction in weight from the baseline level, according to findings released by the Blue Cross Blue Shield Association

Reduced postprandial blood sugar spikes, improved insulin sensitivity, and lower systemic inflammation all contribute to a subjective increase in daily energy

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