
Constant hunger and food cravings can make weight loss difficult, even when you are working hard to improve your diet and stay active. If lifestyle changes have not produced the progress you hoped for, a prescription medication may help you manage your appetite and build healthier habits.
Phentermine and topiramate, sold together under the brand name Qsymia®, offer a once-daily option for medically supervised weight management.
Prima Medicine provides medical weight loss care at convenient offices in Fairfax, South Riding, Merrifield, and Tysons, Virginia. Our team includes Dr. Sylvia Luther, who is certified by the American Board of Obesity Medicine, and Shannon Ross, FNP-BC, who focuses on obesity medicine in addition to family medicine and geriatrics. We take the time to understand your history, challenges, and goals before recommending this prescription or another treatment.
What Is Phentermine and Topiramate (Qsymia)?
Qsymia is a prescription drug that combines two medicines in an extended-release capsule:
- Phentermine helps decrease appetite and may make it easier to eat smaller portions.
- Topiramate may help reduce appetite and promote feelings of fullness, although its exact role in weight loss is not fully understood.
Together, these ingredients can support weight loss when combined with lower-calorie eating, physical activity, and ongoing medical care. Qsymia is taken by mouth, making it an option for those who would rather take a daily pill instead of injectable medications.
Who May Qualify for Qsymia?
Your provider might recommend Qsymia when nutrition, physical activity, and other lifestyle changes have not produced sufficient weight loss. It may be prescribed for adults with:
- A body mass index of 30 or higher
- A body mass index of 27 or higher and at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol)
Qsymia is not appropriate for everyone. It should not be used during pregnancy because topiramate can harm a developing fetus and increase the risk of congenital disabilities, including cleft lip and cleft palate.
It may also be unsuitable for people with glaucoma or hyperthyroidism. It should also not be taken during or within 14 days of using a monoamine oxidase inhibitor. Because the medication can potentially increase heart rate, your care team will also review your cardiovascular history before prescribing it.
What Happens During Qsymia Treatment?

Your first visit includes a review of your weight history, eating patterns, current medications, previous weight loss attempts, and overall health. Your provider might also check your blood pressure, heart rate, body composition, and laboratory results.
Treatment generally begins with a low dose. The dose may gradually increase based on how your body responds. During follow-up visits, your care team will monitor:
- Weight and body measurements
- Appetite and eating habits
- Blood pressure and heart rate
- Side effects
- Medication adherence
- Nutrition and activity goals
Your progress will be reviewed at specific points to determine whether continuing or adjusting the medication makes sense. Do not stop a higher dose suddenly unless your provider instructs you to do so. The drug may need to be tapered gradually to reduce the risk of seizures.
What Results Can You Expect?
Results differ based on your dose, health, eating habits, activity level, and response to treatment. Some people notice reduced hunger soon after starting Qsymia, while weight changes develop gradually.
In clinical trials, about 6 to 7 out of 10 adults taking the recommended or highest Qsymia doses lost at least 5% of their starting weight after approximately one year. Some lost 10% or more, but individual results vary. Your provider will set realistic goals and assess whether the medication is producing enough benefit for continued use.
Why Choose Prima Medicine for Qsymia in Fairfax, South Riding, Merrifield & Tysons, VA?
Weight management involves more than writing a prescription. Prima Medicine provides coordinated medical treatment that considers your weight alongside concerns such as diabetes, high blood pressure, sleep disorders, and elevated cholesterol.
As part of Privia Medical Group, the practice connects patients with physician-directed, multispecialty care when additional support is needed. The team also offers several medication and lifestyle options, allowing your plan to change as your needs and progress evolve.
Build a Healthier Approach to Weight Loss
Phentermine and topiramate may help control hunger and support steady weight loss when lifestyle changes are not enough on their own. Regular check-ins allow your provider to track your response, address side effects, and decide how long treatment should continue.
Meet with Prima Medicine to learn whether Qsymia or another medical weight loss option is right for you. The practice serves patients in Fairfax, South Riding, Merrifield, and Tysons, VA. Call (703) 870-3750 to request an appointment.
