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no insurance required Key exclusions / pregnancy, breastfeeding, personal or family history of medullary thyroid carcinoma or MEN2 Expected weight loss (GLP-1 class) / 10-22% body weight over 68-72 weeks per published RCT data Visit format / asynchronous messaging plus scheduled video consults depending on plan tier Compounded vs
More research is needed to understand how well these medications work together for long-term weight loss, but early experiences suggest that they can be helpful when combined
If persistent, dose reduction may be necessary
This stepwise approach helps minimize side effects, particularly the cognitive and neurological effects that topiramate can cause
Hypoglycemia risk increases when combined with insulin or sulfonylureas