Editor's Note

I've been getting comments from the readers, regarding what diet pill I consider the best. In my opinion, the best weight loss products are those which target the hormones and neurotransmitters that govern your body fat & appetite suppression, and work by multiple mechanisms.

When it comes to prescription diet pills, I recommend Wayt-less (This is a powerful appetite suppressant/carbs & fat blocker in one that contains 3 powerful prescription diet pills – Acarbose (Generic Precose®), Orlistat (Generic Xenical®), Low Dose Naltrexone). You can avail a prescription online using Telemedicine.

Among the natural/herbal/over the counter products, I recommend Lean Optimizer and PhenQ. Check out this comprehensive review on PhenQ.

The functions of these hormones and neurotransmitters is to mobilize the brain and body for action and activities and create a systematic balance of fat and muscle in the body needed for survival. They also provide the appropriate signals to brain and the body's cells whether you should feel hungry/tired or full/satisfied/energetic.

Read more on my recommended diet pills.

In this article, you will read...


The Federal Drug Administration has recently approved two new drugs for assistance with weight loss. Qsymia (pronounced kyoo-sim-ee-uh) is a drug manufactured by Vivus Pharmaceuticals. Arena Pharmaceuticals produces a drug medicine named Belviq, (bel-veek) both drugs have undergone successful clinical trials in benefitting weight loss.

Both Qsymia and Belviq are designed with the intention of aiding obese people with a Body Mass Index, BMI of 30 or higher. A patient with a weight related condition such as high cholesterol, high blood pressure, or type 2 diabetes can be prescribed either drug as long as they have a BMI of 27 or higher. Both drugs are likely to be approved by insurance companies for assisting health conditions related to weight-loss.

Of the two different weight-loss drugs, Qsymia seems to be the more effective, with patients taking Qsymia averaging a weight loss of 9% over those who were issued a placebo.

How Does Qsymia Work?

Qsymia is the combination of two generic drugs: topiramate and phentermine. Topiramate has been known to be primarily used as anti-migraine drug, yet it prevents the absorption of fat in the body. It also provides increasing sensation of fullness. Also, foods have been known to taste less appealing when eaten with topiramate.

Topiramate was originally produced as an anticonvulsant for seizures. Later, topiramate was specifically tested with phentermine, for the purpose of testing as an off-label weight-loss medicine. Topiramate was first approved in 1996 by the FDA.

Phentermine is the other generic drug, and main ingredient in Qsymia. Phentermine is known to have a similar pharmacology to amphetamines, which is often used to treat attention deficit disorder and target the hormone dopamine and neurotransmitter norepinephrine. Phentermine is primarily used as an appetite suppressant helping the patient to stop eating sooner, and eat less.

These neurotransmitters signal a fight or flight response in your body which, in turn, puts a halt to the hunger signal by increasing the blood's concentration of "leptin", the neurotransmitter which basically tells the brain that the body does not require food. This results in loss in appetite because your brain doesn't receive the hunger message.

Here is some more information on leptin:-

Being a combination of two substances that both act as weight loss agents, Qsymia is not exactly similar to Phentermine. The results of clinical trials have shown that Qsymia helps to get rid of 10% of initial weight during the first year already.

The primary reason it got approval was that is happened to be effective and more safe than other phentemrine based diet pills like phen-fen etc.

Is Qsymia the best weight loss pill? Are there better options available?

Here are the primary mechanisms by which Qsymia is supposed to work:-

  • reduction of fat absorption in the body
  • appetite suppression;
  • decrease of insulin levels in the blood;
  • reduced risk of: diabetes, hypertension and hyperlipidemia;
  • anorexigenic effect (helps to stick to a low-calorie diet)

As you can see the Qsymia possesses quite effective properties and might be able to help people in dealing with obesity by targeting different mechanisms. Experts call it optimal for safe and effective weight loss.

However, there are some bad points and there are better options available. Read on.

1. There are some bad reviews around the use of Topiramate for weight loss like this one.

A user with personal experience with Topiramate says -"Regarding the use of Topamax/topiramate as an ingredient in a weight loss drug, I feel this is irresponsible drug mongering of the worst kind. I think, like most other weight loss pills, this will make some people very sick, and will most likely fail on multiple levels, seeing as it only has an 11-26 percent success rate and it has a metric ton of potential side effects, most of which are very serious. This is an antiepileptic, and shouldn’t be handed out for weight loss. There’s also evidence that, much as is seen with standard weight loss medications, once a person is taken off Topamax they return to their natural weight. Not only is there the risk of side effects and birth defects, but there is also the risk of the drug not working at all.
Mainly included as a "fat blocker", in Qsymia to slow down the absorption of fat in the body cells, the efficiency and safety of Topiramate is questionable."

According to this study, long term use can even result in verbal learning, retention, and memory loss and for some users, it might be irreversible.

In summary, TPM as a commonly used AED with additional indications for use in migraine headaches, obesity, and psychiatry has verbal learning, retention, and memory loss as major AEs. While these effects are reversible upon discontinuation of the medication, they preclude a significant minority of individuals from continued use. At this time, it is not possible to predict which patients are most vulnerable to such cognitive effects.
The mechanism by which Topomax(Topiramate) works to exert its migraine reducing effect is still unknown. It has the potential to influence the production or action of certain neurotransmitters in the brain, suppressing the abnormal activity of the nerves in the brain that cause seizures or preventing the abnormal activity from spreading to other nerves.

Other clinical studies document that it might suppress the nerves directly, thereby making them less likely to fire that prevent severe migraines.

All in all, its safety when it comes to weight loss is still in the grey area.

2. Problems with Phentermine

Although Qsymia contains small amounts of phentermine (probably that's the reason for small results), it still has the side effects of Phentermine.

Appetite suppressants like Qsymia(Phentermine based pills) are currently prescribed by doctors to treat extreme cases of obesity and they help very well in dealing with one of the most common causes of obesity, however they come with side effects.

When it comes to prescription diet pills, Wayt-less seems to be a better as well as cost-effective solution to weight loss. Unlike Qsymia, Wayt-less contains 3 ingredients - Acarbose (Generic Precose®), Orlistat (Generic Xenical®), Low Dose Naltrexone). So, with Wayt-less, you are getting a carbs blocker, fat blocker, and an apetite suppresant, all in one. You can get prescription for Wayt-less online.

And there are quite effective, yet safer herbal alternatives to phentermine like Lean Optimizer and PhenQ , available in the marketplace.

Qsymia has all the side effects of Phentermine and Toparimate combined.

3. Qsymia’s other disadvantages

  • A doctor's prescription is required.
  • It acts mostly as an "appetite suppressant", with only mild "thermogenic effect" (increase in burning of calories)
  • It is not available online.
  • If it does not target your hormones and other factors comprehensively, especially the dopamine and brain-reward response, serotonin, acetylcholine, human growth hormone, and leptin-insulin resistance you might be having, that is why it's not be going to be greatly effective, no matter how strong an appetite suppressant Phentermine is.
  • It has a long list of potential side effects.

Some of well known Qsymia side effects are listed below:

  • Restlessness or insomnia
  • Nausea
  • Constipation or diarrhea
  • Elevation in blood pressure
  • Dysphoria
  • Difficulty in breathing
  • Chest pain
  • Dizziness
  • Excessive Tiredness
  • decreased sense of touch
  • dry mouth
  • unusual thirst
  • diarrhea
  • constipation
  • heartburn
  • painful, frequent, or difficult urination
  • hair loss
  • Loss in verbal learning, retention, and memory

4. What is PhenQ?

PhenQ is a herbal diet pill consisting of ingredients and compunds that mimic the actions of phentermine, only without the side effects.

First, PhenQ works as an appetite suppressant so you eat less. This is by the leptin's appetite suppression mechanism, similar to Phnetermine and Qsymia.

Secondly, it makes the body use its fat reserves for energy and raises your metabolism rate. This is the dopaminergic/cholinergic mechanism and the norepinephrine mechanism. The diet pill Contrave also primarily makes use of norepinephrine, albiet in a much safer way than Qsymia because Contrave does not contain phentermine and its side effects.

Finally, ingredients in PhenQ help the body break down fats stored in the body.

This product is effective because of the great combination of five active ingredients.

PhenQ ingredients



PhenQ ingredients include:

  • Calcium Carbonate – 625 mg
  • Caffeine Anhydrous – 142.5 mg
  • L-Carnitine Tartrate -150 mg
  • A-Lacy Reset – 25 mg
  • Nopal – 20 mg – 3 mg
  • Piperine Extract – 3 mg
  • Chromium Picolinate – 80 mcg
  • Capsicum Extract – 8mg

So, in a way PhenQ combines the best of Qsymia and Contrave, without side effects

Capsaicin, a chili pepper extract, helps increase metabolism and breaks down fats. It has several studies backing it, like this one.

It is because of these five ingredients that PhenQ is so effective. Some satisfied users even claim that it is like a combination of Ephedra and Phentermine.

Because it has both - the "thermogenic" effect (burning more calories) of Ephedra and "appetite suppressant" effect of Phentermine, that work in synergy, combined in one.

To make it even better, PhenQ has none of the side effects linked with Ephedra and Phentermine diet pills and other supplements.

It also has L-carnitine that increases acetylcholine levels, another very important energy giving neurotransmitter, that plays a role in insulin balancing and secreting more growth hormone which is great for weight loss.

  • Calcium carbonate raises low calcium levels in the body.
  • Chromium picolinate helps to increase energy levels and decreases food cravings. It also balances insulin levels and helps to deal with insulin resistance.
  • L-carnitine is an amino acid responsible for transporting fatty acids through the body and increasing acetylcholine.
  • PhenQ is effective in:

    • Consuming less calories
    • Raising metabolism rates
    • Burning the body’s stores of fat
    • Preventing muscle loss while dieting and stimulating muscle tissue
    • Increasing energy levels
    • Burning up to 270 calories

    Another powerful phentermine/Qsymia alternative is Lean Optimizer.

  • Citrus aurantium/Synephrine in Lean Optimizer works as a stimulant, boosting metabolism and energy levels. It helps to burn fat too, although very mildly.

5. Qsymia does not target all the mechanisms of weight loss

Modern research has revealed there might be several complex factors behind your weight gain. Eating more is just one of them, and is more of a "side effect" of gaining weight, rather than the real cause.

When you are making use of a weight loss pill, you are basically trying to transform your body’s composition and definition and it is governed by your brain, via several mechanisms.

However, the most crucial unconscious mechanism seems to be the endocrine or hormonal mechanism.

The hormones govern how much body fat or even muscle you will have.

There are many hormones involved like thyroid, testosterone, estrogen, human growth hormone, leptin, insulin, cortisol etc. and they all should be targeted for long term permanent weight loss.

Other factors resulting in weight gain can range from toxins in the body and colon, hormonal imbalances, aging and genetics.

The endocrine/hormonal factor and leptin-insulin resistance are one of the most crucial factors behind weight loss.

Here are some of those crucial hormones which can be manipulated using psychopharmaceuticals weight loss pills -

So if you are looking for a weight loss product that works by comprehensively targeting all these mechanisms, Lean Optimizer and PhenQ are multipurpose natural diet supplement that work.

Qsymia seems to target serotonin but very mildly (unlike Belviq which is primarily a serotonin drug). Qsymia does not target acetylcholine.

It definitely does not target the human growth hormone, while Lean Optimizer targets all the three- serotonin, acetylcholine and human growth hormone.

Moreover, Qsymia does not result in dramatic weight loss, for some users it might not be even significant. It is not a magical weight loss pill. Then, there are some bad reviews of Qsymia as a whole.

Didn't do a thing for me. On day 5 I even doubled both pills. Didn't do a thing. I found nothing on the Qsymia website that suggests it takes days and days to become effective. In fact if you read carefully there, you will always notice they say Qsymia "may" lower your appetite. Qsymia "may" help you lose weight. Well, if you word it that way - you could say the same thing about banana peels. Also, look at their studies regarding it's weight loss results. The average weight loss in a year was a whopping 10%, at best, of the participant's body weight. At least for those who found it effective. Big deal. Do the math. Had I read up on their website, I doubt I would have even given this a shot. - Online user review for Qsymia

Healthy eating habits and an active lifestyle are what work best, and what truly achieves weight loss. Compared to Qsymia, Lean Optimizer and PhenQ are more safe options and can be considered as long term lifestyle pills.

6. The idea behind Qsymia is nothing new and there seems to be some marketing hype.

However, using appetite suppressants like Phentermine and manipulating the levels of hormone "leptin" is a more complicated subject than you might expect, as the mechanisms aren’t always clear.

The best diet pills out there work by influencing several mechanisms simultaneously in your body, and thereby causing weight loss in synergy.

When it comes to prescription diet pills, I recommend Wayt-less (This is a powerful appetite suppressant/carbs & fat blocker in one that contains 3 powerful prescription diet pills – Acarbose (Generic Precose®), Orlistat (Generic Xenical®), Low Dose Naltrexone). You can avail a prescription online using Telemedicine.

Among the natural/herbal/over the counter products, I recommend Lean Optimizer and PhenQ.

These pills are also relatively more safe and can be taken long term.

Drugs like Contrave and Qsymia have been reviewed on the Journal of Clinical Psychiatry too, however the free journal is more a platform for advertisements for the drugs companies. Qsymia also seems to be a case of good marketing.

Not all products advertised on Journal of Clinical Psychiatry are effective, mostly because they put out “supplements” bound exactly like the main journal which aren’t necessarily peer-reviewed and can be high-end academic commercials for drug companies. Although you can find some good peer reviewed products in the main paid journal.

7. When You Should Definitely Not Take Qsymia? With all medications, certain people should avoid specific drugs due to personal allergies, dysfunctions, diseases, and personal comfort and well-being. With Qsymia, following are the conditions:-


Those who are allergic to topiramate or phentermine, or medications such as midodrine (Promatine, Orvatine) should not take Qsymia.

-Sleep Issues

Qsymia usually comes in extended release capsules which are to be taken once per day, in the morning. The medication may cause difficulty falling asleep if taken in the evening.

-Pregnant Women

Women who are pregnant or nursing should not take Qsymia. Phentermine and topiramate taken during pregnancy has been known to cause a birth defect called a cleft palate. The baby can develop this very early during pregnancy, so do not take if you are planning on becoming pregnant. Women who are breast-feeding should also not take phentermine and topiramate.


If you have glaucoma, the condition where in increased pressure in the eye can cause vision loss, it's not likely your doctor will recommend Qsymia to you.

-Overactive Thyroid

Qsymia is not a prescription recommended to those who have been informed they have an overactive thyroid condition.


If you are taking a monoamine oxidase inhibitor (MAOI), or tranylcypromine (Parnate), it's not likely your doctor will wish to prescribe Qsymia to you. You should also not take Qsymia if you have taken any MAOI anti-depressants within the past two weeks.


If you are having surgery, even oral surgery, be sure to inform the doctor that you are taking Qsymia. Some experts believe Qsymia has serious potential for heart valve damage because phentermine, one of the two drugs in the combination, was part of the notorious Fen Phen diet drug combo that caused serious heart valve damage in the 1980s and early 90s.

-Over Heating

Phentermine and topiramate can prevent you from sweating, making it harder for your body to cool down when it gets hot. Avoid exposure to heat, and drink plenty of fluids. Tell your doctor if you are not sweating as usual.

-High Blood Pressure Medicines

If you are taking blood pressure medications you may have to stop or change dose. Consult with your doctor beforehand.

-Kidney Stones

If you already have kidney stones, or are at risk of getting kidney stones, Qsymia is not for you.


It's possible that your mental health might change in unexpected ways while taking topiramate. 1 in 500 people have been known to become suicidal during their treatment with topiramates.


It is not recommended to consume alcohol while on Qsymia, as it may cause disruptions in the central nervous system, also known to cause dizziness or create a light-headed feeling.

As with all medications, speak with your doctor before deciding if this medication is right for you. Be sure to inform your doctor if you have any other health conditions, are on any other medications, or supplements.


The best diet pills out there work by influencing several mechanisms simultaneously in your body, and thereby causing weight loss in synergy. In my opinion using Wayt-less and Lean Optimizer is a much better, safe and long term strategy to target all the hormones and neurotransmitters required for permanent and safe weight loss that we mentioned in this article. Also checkout other prescription diet pills.


This article is not intended to be a substitute of medical advice. Please consult your physician/doctor/health consultant before trying any of the products mentioned in this article.