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Weight loss itself is likely an important contributor
Pharmacologic comparisons: In head-to-head and network trials (SURPASS versus comparators and SURMOUNT for obesity), tirzepatide produced larger mean reductions in HbA1c and body weight than many older agents and often greater weight loss than single-target GLP-1 drugsthis dual agonism is the hypothesized reason
For individuals who do well on phentermine but continue to battle with impulse eating, late night snacking, or emotional food choices, the addition of topiramate can produce meaningful improvements
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