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If thats the case, Fishman says you could talk to your healthcare provider about taking just the phentermine without the topiramate, which will help with the brain fog
Over time, this cycle can cause chronically high insulin and blood sugar levels, leading to weight gain, fatigue, and eventually type 2 diabetes if left untreated
Administration of a GLP-1 RA may decrease glucagon secretion and hepatic gluconeogenesis
"Particularly in small blood vessels that are prone to effects of inflammation and disease in patients with obesity." GLP-1s are also referred to as incretin analogues
doi: 10.1016/j.ghir.2005.06.015 22 ONeillBTLauritzenHPHirshmanMFSmythGGoodyearLJKahnCR
