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Phentermine (Adipex-P): What It Is: Sympathomimetic amine (stimulant) Appetite suppressant Oldest weight loss medication still available Effectiveness: Average Weight Loss: 5-7% of body weight Short-term use only (FDA-approved for 12 weeks) Weight often regained after stopping Mechanism: Stimulates norepinephrine release Decreases appetite Increases energy expenditure Side Effects: Increased heart rate and blood pressure Insomnia Nervousness, anxiety Dry mouth Constipation Potential for dependence Major Limitations: Controlled substance (Schedule IV) FDA-approved for short-term only (12 weeks) Not a long-term solution Cardiovascular concerns Risk of abuse Cost: Generic: $20-$50/month Usually not covered by insurance Who Should Consider: Need short-term appetite suppression Kickstart weight loss before switching to long-term option Cant afford other medications No cardiovascular disease or substance abuse Most experts dont recommend phentermine due to short-term limitation and rebound weight gain

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Tirzepatides added GIP receptor activation may amplify the insulin-sensitizing effect beyond what semaglutide achieves alone, which matters specifically when cortisol is driving the insulin resistance

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