Slow Loser - Anyone else?

[SarahByNumbers 38]

Small update, in case this is beneficial to anyone else going through the same stall & hunger issues in the future!

I met with my Physician's Assistant (we don't see the surgeon post-op in my program - the PA does all the medical legwork) on July 8th since I was stuck in the high 240s for quite a while (roughly 112kg). The PA discussed what I was doing, agreed that I was doing almost everything right, minus somewhat larger portions at meals due to experiencing more hunger. We discussed GLP-1s (Ozempic, Wegovy, Zepbound, etc.), phentermine, topiramate + phentermine, Contrave, and other medication options. Since my insurance would not cover GLP-1s (I do not have diabetes) and they'd all be crazy expensive out-of-pocket, we decided to give the phentermine a try. Note that this is not a good medication to add if you have any history of heart issues - I'm not a doctor, so anything I say is personal anecdote and you should always consult a physician for any changes in your own medications, etc.

Phentermine is a stimulant and an anorectic, which means it reduces appetite and can increase energy. It will NOT cause you to burn more calories without increasing activity, so reducing the amount eaten is critical (and increasing activity helps, too). The PA had me do an EKG in-office that day, and since it came out normal, I was prescribed half of a 37.5mg tablet for the first 4 days, to increase to a whole tablet daily if I still had residual hunger and was tolerating the 1/2 tab well. I did end up going up to the full tablet, as I had no side effects (except for some anxiety the one day I had a cup of coffee in the morning...don't combine stimulants!!).

The result has been that I've dropped 5lbs in the last 2 weeks, and almost a week of that was spent at an outdoor music festival where the food options were far less than stellar (think "carnival foods" - I tried to stick mostly to all-meat options as much as possible, but I did help my spouse with some cheese curds and funnel cake...). I do have Narcolepsy and ADHD, and the addition of a stimulant has been a bit helpful for those conditions, as well. Another plus was that it cost me roughly $7 USD to fill at my pharmacy with insurance, so it was far more affordable for me than the GLP-1s would have been. My hunger has been curbed quite a bit, and this has helped me feel satisfied eating far smaller portions than I was eating previously.

I have a check-in with my PA towards the end of August, and I'm pleased with my progress so far! I had an annual physical with my General Practitioner last week, and my A1C says I'm no longer pre-diabetic 😁