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Limitations, Long-Term Considerations, and When to Consider Phentermine-Topiramate Even though it works well, phentermine has important limitations: FDA approval remains limited to short-term use Appetite suppression may diminish over time (tolerance) Not ideal for patients with uncontrolled anxiety, insomnia, or hypertension Does not improve metabolic markers (A1C, cholesterol) like GLP-1 therapies For longer-term taste control, combination options such as phentermine-topiramate may offer more sustained benefit under medical supervision

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