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Side Effects Both medications come with potential side effects: Semaglutide: Nausea and vomiting Diarrhea or constipation Low blood sugar (hypoglycemia) Topiramate: Dizziness and fatigue Numbness or tingling in the extremities Mood changes or difficulty concentrating While side effects may vary from person to person, they often diminish over time as the body adjusts to the medication

By rewiring these signals, the treatment helps reduce persistent hunger and food noise, making it easier to adhere to a healthy nutritional plan

My energy feels steady and reliable again, classroom management is smoother, and Im far more present with my students

Lorenz M, Pfeiffer C, Steinstrasser A, et al

The 4mg dose remains a reasonable target for those who can't tolerate higher doses while still producing clinically significant weight loss