why phentermine stopped working

Why Phentermine Stopped Working

Phentermine is an FDA-approved weight loss medication for weight loss in adults. Phentermine’s primary mechanism of action is the release of norepinephrine from the brain causing a suppression of appetite, increase in energy, and release and break down of fat. Phentermine works best when used with proper nutrition and adequate physical activity and should be monitored by a doctor.

Phentermine is not an amphetamine but works similarly to well known amphetamines, however, does not cause addiction or physical dependency.

Did phentermine stop working or did you stop working?

why phentermine stopped working

The first step is to determine if your eating habits and level of activity are to blame. Below are a few questions to consider:

  • Are you stalling on the scale but losing body fat, inches, or going down in clothing sizes?
  • Are you taking phentermine daily first thing in the morning?
  • Are you drinking enough water?
  • Are you following the nutrition recommendations set by your doctor?
  • Are you logging your food intake to uncover hidden carbohydrates, sugar, and/or calories?
  • Are your food portions too large?
  • Are you consistent or do you only follow the proper plan part time?
  • Are you falling back into bad habits from the past?
  • Do you need to increase your physical activity level?


Phentermine is not a magic pill; it is a tool that aids in weight loss when used correctly. If you want to experience lifelong results take phentermine with the expectation to change daily habits and food choices. As you continue to make these changes consistently you will transform your physiology and create a new weight set point in the brain that supports a lower weight.

Why does phentermine wear off?

The effects of phentermine are diminished over time due to drug tolerance. Tolerance is when a medication loses potency over time after repeated use and as a result the individual experiences less response from the drug.

Although phentermine is not “addictive” it results in tolerance over time. Tolerance can be good and bad and occurs due to the body’s attempt to create homeostasis (or a predictable balance). In the case of phentermine, reduction in thirst and insomnia can be beneficial; however, losing appetite suppression and energy is less desired.

How it happens?

Phentermine binds to receptors in the brain and releases norepinephrine. The norepinephrine results in weight loss, however, over time these receptors downregulate (reduce in number) so that less norepinephrine is released from the brain over time. The overall impact is the individual taking the medication notices the results are less potent than before.

How will I know if phentermine stopped working?

  • More consistent hunger
  • Able to eat larger portions than previously
  • Need more food to feel satiated
  • Cravings that were better controlled return
  • Prolonged weight plateau (2-4 weeks)

How long will phentermine last? 

The amount of time that phentermine lasts varies based on the individual. Some people have no effect from phentermine, others notice the original impact wears off quickly while others will experience the same effect for several weeks to several months.


What should I do if phentermine stops working?


#1. Don’t freak outw

Don’t give up on your weight loss goals. Don’t give up!

Resist the urge to entertain negative thoughts regarding your ability to successfully lose weight, this will only make matters worse.

The first thing to do is RELAX. If phentermine stops working it is not the end of the world.

If you followed a proper routine for weight loss, diet, and exercise- you will likely maintain the weight that you’ve lost and even lose more. On the contrary, if you skipped multiple meals, ate unhealthy foods, and made no efforts to make sustainable healthy changes, you may regain all the weight lost and then some (watch Dr Covington’s video “The Most Common Mistakes People make with Phentermine”).

It's important to avoid the most common mistakes that individuals make when taking phentermine if you want long term weight  loss success. 

In addition to not freaking out, avoid restrictive diets, extreme exercise, or unsafe supplements.

#2 Talk to your Bariatrician

Your weight loss doctor is a great resource to walk you through what to do next. Your doctor may stop phentermine or employ techniques to make the medication more effective.

Check out our Blog article --> How to Choose a Weight Loss Doctor 

#3 Increase physical activity

Exercise releases norepinephrine (similar to phentermine but the effect is much shorter) and may provide a similar appetite suppressing effect and boost in energy. The increased exercise will also counteract any rebound in diet or cravings that you may have. Positive endorphins released from exercise will also help to improve mood so that you can remain optimistic regarding your weight journey.

#4 Take a “drug holiday”

A drug holiday involves intentionally stopping a medication for a period of time with the intention of restarting it at a later date. A drug holiday should be facilitated by your doctor, you don’t want to stop phentermine unnecessarily or incorrectly.

Brain receptors change in number based on the stimulus so when phentermine is removed the norepinephrine receptors up-regulate again (or increase in number). A drug holiday often allows the brain receptors to reset and can improve phentermine effectiveness if it is restarted.

As many frustrated patients have experienced, phentermine can become less effective over time due to drug tolerance. The amount of time for phentermine’s effectiveness varies so maximize your results by making lifestyle changes. If you make lifestyle changes the goal you will experience weight loss results that last a lifetime.

Watch Video "How Phentermine Works"

Schedule Appointment with Dr Covington

weight loss medicine

FDA Approved Weight Loss Medications & How They Work

Over 75% of Americans are overweight with over 30% obese; therefore, weight loss solutions are imperative. A bariatrician is a medical doctor who treats patients with excess fat and diseases related to extra weight such as high blood pressure and joint pain. In addition to nutrition, physical activity, and behavioral health, a bariatrician often uses FDA approved weight loss medications as a treatment for obesity. Obesity is not only the most common medical condition that adult patients share but it is also linked to deadly diseases such as heart disease, fatty liver, and various cancers. Unfortunately, obesity is severely under treated and as a result many individuals resort to ineffective or dangerous methods for weight loss.

In most cases if a doctor prescribes one of these medications for weight loss it is because the risk of overweight or obesity outweighs the risk of the medication.

This article discusses safe and effective FDA approved weight loss medications and how they work.



Why FDA Approval Matters

The Federal Drug Administration (FDA) is a government agency that regulates medications prescribed in the United States for safety and efficacy (or effectiveness). All medications have side effects; however, drugs approved by the FDA are studied for several years in volunteer patients to determine how they work and the most common side effects. Several medications require additional testing even after FDA approval. FDA approved weight loss medications must demonstrate more weight loss when compared to diet and exercise alone and/or a placebo. On the contrary, non-FDA approved substances have not been tested under strict regulatory guidelines and have not been required to show superior results to placebo or diet and exercise alone.

weight loss center in charlotte nc

How Much Weight Will You Lose?

The amount and rate of weight loss depends on the medication, the starting weight, the individual, and how well one follows proper nutrition and physical activity recommendations. On average, weight loss medications will yield twice the amount of weight loss when compared to placebo and diet and exercise alone. In the case of “resistant weight loss” sometimes a weight loss medication is the only way people are able to successfully lose weight despite their best efforts. The amount of weight loss can range anywhere from 20-40 pounds to over  100 pounds and depends on the amount of excess fat on the body. In addition, weight loss medication can be used after bariatric surgery for patients who experience weight regain.


What is the criteria for weight loss medication?


In order to qualify for a weight loss medication, you must have a Body Mass Index (BMI) greater than 30 or a BMI greater than 27 (overweight category) with at least 1 weight related co-morbidity (such as sleep apnea, joint pain, or diabetes).

The BMI is the ratio of weight to height and can be over-estimated for individuals with a lot of muscle mass or underestimated for individuals with a low body weight and high body fat percent (since it does not account for body composition). You can calculate your BMI using our BMI Calculator on the bottom right corner of the website's home page.

Underweight Below 18.5
Normal Weight 18.5-24.9
Overweight 25-29.9
Obese 30-49.9
Morbidly Obese 40 -49.9
Super Obese 50-59.9
Super Super Obese 60 and Above


FDA Approved Weight Loss Medications

#1 Phentermine - Adipex, Suprenza, Lomaira

 Phentermine is the #1 prescribed weight loss medicine in the United States and was first approved in 1959. Phentermine is popular for it’s appetite suppression and energy producing effects that lead to weight loss. Phentermine comes in the form of a tablet, capsule, or disintegrating pill (Suprenza) and works by releasing norepinephrine; a brain chemical that can reduce food intake, increase energy and metabolism, and break down fat. The medication is taken in the morning because it can cause insomnia or difficulty sleeping. The most common side effect is thirst from dry mouth; however, phentermine can also cause feelings of nervousness, increased heart rate, heart palpitations, increased blood pressure, chest pain, headache, and dizziness.

Phentermine is not safe for everyone, especially those with a history of heart disease, therefore, a prescription from a doctor is required along with routine monitoring.

Lomaira is a special formulation of phentermine in a low dose. It may be better tolerated due to the smaller dosage and can be taken up to 3 times a day.

 Check out Dr Covington's Youtube Videos on Phentermine 

Phentermine and How it Works

Most Common Mistakes People Make with Phentermine

#2 Qsymia (phentermine and topiramate)

Qsymia was FDA approved in 2012 and is the combination of two medications that both impact weight loss separately. Phentermine is an appetite suppressant while topiramate aids in binge eating and cravings; the combination of these two medicines enhances weight loss results. Topiramate is also used to treat seizure disorder and migraine. In clinical studies, Qsymia demonstrated an average weight loss of 8.5% when compared to placebo, with almost half of the patients losing more than 10% in the first few weeks.  Qsymia should not be taken by pregnant women or women seeking to get pregnant (this is common for all weight loss medications) and can cause dizziness, constipation, numbness, unusual taste, dry mouth, difficulty sleeping, and changes in mood. Women of childbearing age are strongly recommended to take a monthly pregnancy test and use birth control or barrier protection when taking this medication.

Check out Dr Covington's Youtube Video discussing Qsymia and How it Works

#3 Belviq and Belviq XR (lorcaserin)

Belviq is a weight loss medication approved in 2012 that causes a release of serotonin in the brain. Belviq comes in 2 forms, one is immediate release that is taken twice a day and the other is extended release and can be taken once a day. Belviq works by reducing appetite, hunger, and cravings along with the ability to get full quicker with less food. Common side effects are dizziness, headache, fatigue, constipation, diarrhea, nausea, and dry mouth. Belviq may also benefit patients with obesity and diabetes as it demonstrates an independent ability to reduce hemoglobin A1c, a lab value used to determine the severity of diabetes.

phentermine in charlotte

 #4. Contrave (naltrexone and bupropion)

This weight loss pill is comprised of two previously approved drugs, naltrexone and bupropion. Buproprion is used for depression and smoking and has been shown to reduce hunger and aid in weight loss. Naltrexone is used for alcohol cessation but enhances the effect of bupropion by adding to the reduction in hunger and cravings. Contrave was approved in the United States in 2014. Clinical trials demonstrate that close to 50% of patients lost at least 5% of their excess weight when compared to placebo. Like Qsymia, Contrave follows a weekly titration until reaching the target weight loss dose. Contrave can increase heart rate (2-3 beat per minute) and cause constipation and diarrhea, headache, dizziness, insomnia, nausea, vomiting, and dry mouth, and should not be used in anyone with a history of seizures of liver disease.

#5. Saxenda (liraglutide)

 Saxenda, approved in 2014, is unique from the other weight loss medications in that it is an injection of a “biologic” that must be refrigerated, whereas the other weight loss medications are pills. Saxenda is a glucagon-like peptide-1 (GLP-1) product which means it is a satiety hormone that is already produced in the body. Saxenda works by enhancing satiety and helps individuals feel full and eat less calories. The medication is injected once a day in the abdomen, arm, or thigh and is titrated up over a 5-week period until the top dose is reached. The most common side effect is nausea but can also cause headache, diarrhea, constipation, abdominal pain, and an increase in heart rate.

6. Wegovy,  Ozempic, and Rybelsus (Semaglitide)

 Wegovy is the newest FDA approved weight loss medication (to date), approved in the summer of 2021, and it is similar to Saxenda in that it is a glucagon-like peptide-1 (GLP-1) and biologic that requires refrigeration. Wegovy and Ozempic are practically the same medication but approved for different indications. Wegovy is FDA approved for weight loss and Ozempic is approved for use in Type II diabetes. Wegovy and Ozempic also differ in dosing, with Wegovy’s maximum dose being 2.4 mg when Ozempic ends at 1 mg. The medications also differ in the construction of the injection pens and medication delivery. Wegovy is an “autoinjector” pen with the needle inside the pen and one-time use for each injection. The Ozempic injection is more tedious requiring pen needle insertion and a dial to increase or lower the dose. Both Wegovy and Ozempic have longer half-lives than Saxenda, allowing for an injection once every 7 days as opposed to the once daily injection needed for Saxenda. Wegovy works by increasing satiety and helping individuals to feel fuller, this results in reduce food intake and appetite. Wegovy also lowers insulin (to aid in fat loss and insulin resistnce) and slows down digestion.

Individuals who take Wegovy report less hunger, smaller portions of food, and less eating frequency. Patients notice getting fuller sooner after eating and therefore eat smaller portions of food, they may snack less frequently and eat less often between meals. The most common side effects for Wegovy are similar to the side effects for Saxenda and Ozempic and include nausea, headache, diarrhea, constipation, and abdominal pain. Wegovy, like the other GLP-1s in the class, has improved cardiac outcomes by lowering heart attack and stroke risks.

In clinical trials, 86% of participants taking Wegovy lost at least 5% body weight, 50% lost at least 15% body weight and participants who completed 68 weeks of the trial lost on average 15.3kg (33.7 lbs) compared to 2.6 kg (5.2 lbs) body weight in the placebo group.

Rybelsus is the only FDA approved oral GLP-1 and does not require injection or refrigeration. It is FDA approved for Type II Diabetes.

 #7. Orlistat (Xenical, Alli)

 Orlistat is approved for weight loss and works by reducing the absorption of fat from food. The medication comes in 2 versions, one is Xenical which requires a prescription and the other is Alli (a lower dose) that is available over the counter. The medication can reduce dietary fat absorption by as much as 25%. Orlistat is the only weight loss medication approved for use in children.  The most common side effects are stomach pain and loose stools which can occur with a fatty meal; therefore, patients are advised to eat a low-fat diet to reduce this effect.


#8. Diethylpropion, Benzphetamine, and Phendimetrazine (Bontril)

 These medications are appetite suppressants that work similarly to phentermine but may be tolerated differently based on their chemical structures. All of these medications were FDA approved in the 1960s with the exception of the extended release version of diethylpropion which was approved in 2011. The side effect profiles are similar to phentermine and all can cause dry mouth, insomnia, heart palpitations, dizziness, and irritability.

#9 Plenity

Plenity is different than most of the FDA approved weight loss medications for a few reasons, first it can be prescribed at a BMI as low as 25 and second, it contains natural products and no chemicals. Plenity is  not a medication it is considered a "medical device" and it is comprised of simple ingredients: cellulose which is a natural fiber-like substance found in fruits and vegetables and aids in fullness and citric acid (found in citrus fruits).

Plenity works by taking 3 capsules twice daily at lunch time and dinner with 16 ounces of water, the hydrogels of Plenity mix with food and water and expand in the stomach and gut to make one feel fuller and eat less at meals and throughout the day. Currently, there is no limit to how long one can continue Plenity and it is not habit forming. This medication although FDA approved and requiring a prescription is not covered by medical insurance and retails for approximately $98 a month. In clinical trials, 60% of patients taking Plenity lost 10% of their body weight, approximately 20 lbs, in 6 months.

The most common side effects for Plenity are GI related and include: diarrhea, gas and bloating, abdominal distention, and infrequent bowel movements. In comparison to clinical trials participants taking Plenity did not have more adverse events than participants taking placebo. Plenity is not recommended as first line treatment for obesity in patients with a BMI over 40.



Weight Loss Medication is Not a Magic Pillhow to lose fat

Weight loss medications are tools for weight loss that serve several purposes. Weight loss medications help with appetite, cravings, energy, and fat loss but they are NOT magic pills! All FDA approved weight loss medications require proper monitoring with a licensed medical doctor and are used along with healthy nutrition and exercise.


If you are looking to get started in a medical weight loss clinic in Charlotte NC or the surrounding area give us a call at 704-997-9661 or request an initial weight loss visit here.

phentermine doctor in charlotte

Most Common Mistakes People Make with Phentermine

Phentermine is an FDA approved weight loss medication that is used to control appetite, it is approved for individuals with a body mass index (BMI) that meets medical criteria for obesity – a BMI over 30 kg/m2 or a BMI over 27 kg/m2 with obesity related medical conditions such as high blood pressure, sleep apnea, or weight related joint pain. Phentermine effectively reduces hunger, cravings, and increases metabolism and for these reasons phentermine is a popular medication used for obesity and medical weight management. Phentermine is the oldest and arguably one of the most effective weight loss medications on the market, to add, it is the cheapest weight loss medication and therefore easy to access in most pharmacies across the country. Phentermine is the most commonly prescribed weight loss medication in the United States, however, despite phentermine’s vast use and longevity on the market there are common mistakes that patients make that can reduce short and long-term weight loss success.

Not Eating Enough and Skipping meals


I know what you’re thinking, isn’t the point of phentermine to NOT eat? No, it’s not. This is one of the biggest misconceptions with phentermine. Phentermine is not a starvation pill! The purpose of phentermine is to help control weight gaining signals in the body such as uncontrolled appetite, excess hunger, increased fat storage, poor food choices, and slow metabolism to aid in weight loss. Phentermine’s primary mechanism of action is to reduce appetite, however, not eating or skipping meals is not the goal and will lead to more problems in the long run. Many are aware that muscle weighs more than fat, when we lose muscle during a starvation or restriction diet it can be very exciting to see large weight loss on the scale, however, the muscle loss will eventually turn into a reduction in basal metabolic rate (BMR) which will make future weight gain easier. This is one phenomenon that can occur when patients misuse phentermine, they lose large amounts of weight to only gain it all back in a few months.

The next reason for Proper nutrition is imperative for all human beings, we all need the right combination of micro and  macronutrients in order to survive, using phentermine to aid in starvation is not the right method for weight  loss, primarily because it will not last beyond a few months and additionally because it can lead to poor nutrition and Many people using phentermine tend to make the mistake of starving themselves for too long, thinking this will stimulate the weight loss process.

Poor Diet and Improper Nutrition


Nutrition is the nourishment for humans responsible for health, wellness, and growth. The body needs nutrition. There are different schools of thought on the amount, timing, and type of nutrition but the one thing that we can all agree on is that a body lacking proper micro and macronutrients will not survive.

Poor or malnutrition can range from inadequate vitamins, minerals, micro and macronutrients to excess “bad” or toxic foods that can lead to various diseases and increased morbidity. Phentermine is a tool that helps reduce the intense hunger and many of the cravings for the wrong foods that lead to weight gain so that individuals can focus on the right foods, smaller portions, and proper nutrient balance. Proper nutrition will not only maximize weight loss results, increase energy and overall performance, but will reduce nutritional deficiencies, fatigue, and the rebound hunger and cravings that occur as a result of “crash diets”

Overestimate Phentermine


FDA approved weight loss medications are great tools; however, they are not magic pills. There is no magic, all weight loss occurs from controlling negative physiology that leads to weight gain and introducing positive habits and physiology centered around weight loss. Weight loss physiology involves more than just diet and exercise, there are multiple factors such as proper stress management, sleep, hormonal balance, environment, emotions, and many more. When individuals overestimate the effect of phentermine they are setting themselves up for disappointment. The medication has a wide range of effectiveness that is dependent on the person taking the medication along with their medical and obesity history, habits, other medications, and various other factors. Phentermine does not work for everyone, although there are individuals who will have a great response with phentermine for several months there are some who will have absolutely no response with phentermine, others who will have minimal to limited effect, and several who will have an effect that may quickly wear off. Phentermine works best in coordination with a proper diet and adequate physical activity, taking phentermine without changing poor habits will not create long-term weight loss and will increase the likelihood of future weight regain.

Taking Phentermine at the Wrong Time


Phentermine is a once a day medication that should be taken first thing in the morning. Taking the medication on an empty stomach or with food is not as important as making sure to take it early in the day. One of the side effects of phentermine is energy and focus which can lead to insomnia or trouble sleeping. The likelihood of insomnia increases the later in the day that the medication is consumed. It is important to that the medication in the morning so that sleep quantity and quality is uninterrupted, it’s important to remember that proper sleep is equally effective for weight loss.

Skipping or Forgetting to take Phentermine


It is important to take all medications as directed by the doctor, phentermine is no different. Taking phentermine daily especially in the beginning is very important. While phentermine is aiding in appetite reduction, increased metabolism, and elevated energy, stopping the medication or skipping phentermine can have the opposite effects. Premature discontinuation of phentermine may lead to intense hunger, cravings, and fatigue.

Phentermine is a great tool for managing and treating the disease of obesity, however, it is imperative to use under direct supervision of a physician or medical weight loss doctor and as directed with a comprehensive weight loss program.


Want to learn more?


Watch Dr Covington's video discussing the most common mistakes people make with phentermine

Watch Dr Covington’s live video discussing phentermine and how it works


phentermine blog pic-min

How Phentermine aids in Weight Loss

Phentermine or Adipex is commonly used for weight loss in combination with diet and exercise. Although phentermine is one of the oldest FDA approved weight loss medications on the market there are still a lot of questions regarding its safety and efficacy. Does phentermine work long term?  Is phentermine necessary for weight loss? Is phentermine safe? All of these questions are valid. To answer these concerns along with how the most commonly prescribed weight loss medication in America aids in weight reduction we will explore a few key factors, starting with phentermine’s mechanism of action.

How Phentermine Works

Phentermine is a medication that is only available by prescription. It requires physician monitoring because it is categorized as a “controlled substance”. Phentermine is not a magic pill, it is simply a tool used to help with weight loss. The mechanism of action for phentermine causes a release of norepinephrine from the brain. Norepinephrine (also known as adrenaline) is a natural neurotransmitter produced and released in the body. This chemical is present when we are afraid, nervous, or involved in an action that requires energy, such as moderate to rigorous exercise or running from a bear (hopefully the latter never happens). As luck would have it, the release of norepinephrine from the brain also happens to promote several weight reducing activities such as appetite suppression, heightened attention and awareness, increased circulation of oxygen and nutrients throughout the body and increased metabolism. The increased oxygen circulation increases oxygen supply to the brain, which allows for rapid decision-making, and the activation of large skeletal muscles, which allows us to run from danger if necessary. This cascade of events is called the “fight or flight” response.

In addition to appetite suppression, norepinephrine reduces the thoughts, obsessions, and preoccupations with food. This is why some individuals taking phentermine may forget to eat because they don’t even think about food anymore. The metabolic increase from norepinephrine causes an increased use of stored body fat and an increased uptake of calories at rest in a 24-hour period.

If you are wondering why we don’t experience weight loss on a normal daily basis due to this presence of norepinephrine, it’s simply because norepinephrine only sticks around for a few seconds before it is broken down by the body.

Now that you understand how norepinephrine works, you also understand how phentermine works, it causes a release of norepinephrine and therefore turns on fat burning and counteracts the body’s natural resistance to weight loss.

How much weight will you lose on phentermine?

For all FDA approved weight loss medications, results will vary. On average individuals using phentermine can expect to lose twice the amount of weight that they would lose with diet and exercise alone. This means that if the average rate of weight loss is 8-10 pounds a month that a patient on phentermine may lose twice this rate, 16-20 pounds a month. This is of course considering that there are no counteractive medications, medical conditions, or other hindrances.  It is normal for the weight loss seen in the first few weeks to slow down to a more steady pace over time. This will occur even more for individuals closer to ideal weight. The most significant results, however, are those witnessed by the truly weight loss resistant. This is the individual who fails to lose weight despite multiple attempts over an extended period of several years. For this individual, phentermine can be the catalyst to finally turn on fat burning and when this occurs any weight reduction is extraordinarily significant!

What not to do on phentermine – the "Phentermine Commandments"

  • Thou shalt not skip meals
  • Thou shalt not severely restrict calories
  • Thou shalt not rush the process
  • Thou shalt not ignore nutrition and macronutrient balance
  • Thou shalt not ignore physical activity
  • Thou shalt not skip doctor’s appointments or routine monitoring


Despite the weight loss achieved while taking phentermine resist the urge to skip meals or severely restrict calories because this will only backfire long term. Also resist the urge to speed up weight loss results or create unrealistic demands. Keep in mind that phentermine is a weight loss tool, not a Genie in a Bottle, you cannot expect to lose all of your excess weight overnight.

What to expect when starting phentermine? Is phentermine safe?

Phentermine, like any medication, is safe when used for the right patient and when prescribed by a knowledgeable and experienced physician. Many medications can be refilled without routine check-ins with the doctor, however, phentermine is not one of those medications. Phentermine requires routine monitoring, physical examinations, vital sign checks, and regular office visits to discuss side effects.

What are the most common side effects for phentermine

The symptoms caused by phentermine will vary according to the patient but the most common side effects are appetite suppression and thirst. Thirst can occur as early as the first day and is easy to fix by simply drinking plenty of water. Other common symptoms are increased energy which can lead to insomnia or trouble sleeping. For this reason, it is recommended to take phentermine first thing in the morning. Thirst and insomnia typically subside after the first few weeks but for individuals with severe insomnia your doctor may decide to avoid phentermine altogether. Phentermine can also increase anxiety and other mental diseases such as bipolar disorder. Lastly, the most significant side effect of phentermine is an increase in heart rate and blood pressure along with heart palpitations. All of these symptoms along with other less common side effects not mentioned in this article must be monitored by a doctor.

Is phentermine addictive?

The short answer is not typically. Phentermine is in the class of medications known as amphetamines due to it’s chemical structure and action in the brain. However, it is not a chemical that patients typically get addicted to. Individuals who have successfully lost weight with phentermine may develop a psychological dependence, meaning they may emotionally feel fearful of regaining weight off the medication or feel like they are unable to make healthy decisions without taking phentermine. Some may even notice a physical increase in hunger and cravings once no longer taking the medication.

Will phentermine stop working over time?

It depends. For some people the answer is yes, after several months appetite suppression will subside.  For others, the effects of phentermine remain for a much longer period. Phentermine is not effective for everyone. If phentermine is ineffective for weight loss, meaning an extensive plateau, lack of appetite suppression, or minimal to no weight loss results over an adequate period, it should be discontinued. In this event, a weight loss doctor like Dr Covington can recommend an alternative treatment or FDA approved weight loss medication for you.

Phentermine requires a comprehensive weight management plan

This medication promotes weight reduction by providing energy, focus, suppressing food intake and reducing the desire to eat. Individuals undergoing a weight loss plan are able to make healthier food choices and pursue physical activity without hunger and fatigue. However, this medication is most effective when combined with a comprehensive weight management plan that includes medical oversight, nutrition, physical activity, and routine medical monitoring.

Want to learn more? Watch Dr Covington’s live video discussing phentermine and how it works.

HCG for weight loss

How HCG Aids in Weight Loss? Spoiler Alert… It doesn’t

It’s shocking that the HCG method for weight loss is still around, especially considering that HCG for weight management has never been approved by the FDA, any physician licensed medical body, and most individuals will admit that they do not know anyone who has sustained long term weight loss with HCG. The largest bodies of licensed weight loss experts from organizations such as the Obesity Medicine Association (OMA), The Obesity Society (TOS), Obesity Action Coalition, and American Society for Metabolic and Bariatric Surgery all agree that there is no evidence to support HCG weight loss. In November 2016 the American Medical Association took the official position that HCG did not lead to weight loss or improved human health; a position that OMA adopted 6 years previously. These positions were based on studies that demonstrated HCG injections with a 500-calorie diet versus a 500-calorie diet alone did not produce significant weight loss or appetite suppression. Despite all of this evidence, many weight loss clinics tout HCG and the accompanying HCG diet as safe and effective for weight loss.  This is simply not true.


What is HCG?

Human chorionic gonadotropin (HCG) is a hormone produced by pregnant females. This hormone is detected by home pregnancy tests and is used to confirm whether a woman is pregnant. HCG is not (usually) produced in males or non-pregnant females; with the exception of cancers such as testicular or ovarian cancers. The purpose of HCG is to produce additional hormones (in higher than normal amounts), such as estrogen and progesterone, that are required for a healthy pregnancy. Once these necessary hormones reach the correct levels to support the growing fetus (this typically occurs in the first 12 weeks) HCG decreases and returns to original pre-pregnancy hormone levels. This may explain why most programs utilize HCG for only 3-6 weeks.


The HCG diet and weight loss claims

The HCG diet is a 500 calorie diet that is low in sugar and starches and, at least for the first few days, is high in fat. It is basically a low carbohydrate or ketogenic diet. Supporters of the HCG diet claim that using HCG. The weight loss programs endorse a 1 lb loss a day. Unfortunately, there is nothing about HCG that will reduce appetite, but there is nothing about HCG, elevated estrogen or progesterone that will help with satiety! It is true that the first few weeks of pregnancy that some women will develop nausea or vomiting but it is also true that most pregnant women actually have an increased appetite. Taking more of these hormones will not guarantee appetite suppression at all. For individuals who use this diet, they may experience fatigue, headaches, nausea, or abdominal pain the first few days and that is due to caloric restriction. Over time, the body learns how to adjust to almost any diet, and the natural appetite suppression, if any, is really coming from eating less food, smaller portions, and less sugar. The other claim for HCG is that it can preserve the loss of muscle that often happens with very low calorie diets. This is controversial because the HCG diet is usually a higher protein diet and this alone will help with muscle preservation and lean muscle mass. Also, muscle composition and basal metabolic rate are not always measured before and after the program, so how can this be proven?


HCG Injections

The idea behind the injection is related to the best method for absorption. HCG cannot be taken in a pill form because it will be degraded by the GI tract, so the injection bypasses digestion and allows for proper absorption in the body. It can also not be absorbed as a drop, spray, pellet, or topical form. The HCG injections that are available in the pharmacy are only FDA approved for women who have difficulty with ovulation or supporting a normal pregnancy. Therefore, most individuals taking HCG are getting it outside of a licensed pharmacy. The FDA discovered hundreds of fraudulent forms of HCG in retail stores and in online shops. Sadly, there are even licensed medical professionals selling HCG directly from their offices, outside of FDA and Drug Enforcement Agency (DEA) regulation. Unregulated HCG is not guaranteed to be safe. The FDA first banned the use of HCG for weight loss in 1976 and again in 2011 by prohibiting the sell of homeopathic and over the counter HCG preparations and deeming their use and promotion as illegal. Kevin Trudeau, a non-licensed layperson, misrepresented claims for the HCG diet in the 1990s and made millions by promoting fraudulent books and infomercials supporting HCG weight loss. He was later sentenced to pay $37 million dollars and eventually ordered to federal prison.

Side Effects

HCG is not benign. It can create fertility difficulties for women by overstimulating ovaries and testosterone and can feed hormonal cancers.

What you can do

Now that it is clear that HCG is not a weight loss option, it is time to explore real solutions. First, avoid any weight loss practice using HCG, it is harmful, not proven, and a scam. Do not align yourself with any clinician or provider who is practicing fake medicine.

Now if you are serious about this weight loss journey, the best place to start is by taking a personal mental inventory. Check in with your heart, soul, and mind. Are you ready to make a real weight loss commitment? Do you understand the journey that your body has been on that has lead to excess weight? Tools such as our free Weight History Chart can help you see the patterns for weight gain in your life. If you are ready to make a commitment, start by seeing a licensed weight loss doctor. This specialist will cut down on the trial and error, failed attempts, and confusion! A bariatrician (or obesity specialist) will help you lose weight in a controlled and safe environment. There are many methods for weight loss, find the one that is best for you without risking your health, wasting time, and wasting money!