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Topamax For Weight Loss: How It Works, Dosage, & Individual Variation

Topamax (Topiramate) is an anticonvulsant medication that is primarily used for the treatment of epilepsy, but has also been approved for migraine prevention and as an adjunct to phentermine for weight loss. It is also commonly used as an off-label medication to treat bipolar disorder as well as borderline personality disorder, but there is no conclusive evidence to support its efficacy in these conditions.

Despite the drug being effective in reducing the prevalence of seizures, its mechanism of action that produces therapeutic effects is unknown. Some speculate that it alters voltage-gated sodium channels as well as various calcium channels within the brain. Others believe that it may affect GABA receptors, AMPA receptors, and carbonic anhydrase isoenzymes.

Topamax & Weight Loss

Regardless of how the drug works, it is known that it is often used as an off-label pill to lose weight. Although not everyone will lose weight from taking Topamax, many people lose a significant amount throughout their treatment. It is also important to mention that although it isn’t approved as a standalone drug for weight loss, it is included in the formulation known as “Qsymia” which is approved specifically for weight loss.

How Topamax Works for Weight Loss

The mechanism behind how Topamax works is relatively misunderstood. It has been tested in clinical trials for weight loss, but was inevitably discontinued as a result of people experiencing a significant number of adverse effects. Although the drug never lasted in clinical trials for weight loss, many doctors are knowledgeable that patients taking Topamax are likely to lose some weight. Below is a list of factors that may influence how Topamax works to promote weight loss.

  • Addiction centers of the brain: It is speculated that Topamax may be targeting the addiction centers of the brain with its mechanism of action. Individuals that previously sought out pleasure-inducing substances like food, alcohol, and drugs no longer do so. This is because Topamax may change neural pathways within the addiction control center of the brain. It may also reduce overexcited nerves within this region.
  • Appetite reduction: Many people taking this drug experience appetite reduction or suppression as a side effect. It isn’t exactly known as to how this drug may supress appetite, but some believe it ties into the reward center of the brain. The drug may numb or alter the way rewards are processed, leading to people feeling less hungry or experiencing less cravings for food.
  • Hormone alterations: Another school of thought suggests that the drug may be altering levels of hormones such as cortisol and leptin. Specifically the drug may be decreasing the amount of leptin that is found in cortisol, as well as cortisol itself. Leptin is a hormone that regulates appetite, and when reduced, people tend to feel less hungry. Also when cortisol (the stress hormone) is reduced, the body tends to store less fat, which will lead to weight loss.
  • Disorientation: Those that take Topamax may feel so disoriented as a result of their treatment, that they may have a difficult time functioning and remembering to actually eat. While this may sound silly, this drug can have potent effects on memory, lead some people to feel dizzy, and result in profound disorientation. Those that feel disoriented as a result of treatment may forget to eat or may not want to eat as much.
  • Ketosis: This drug may also be affecting levels of blood glucose as well as insulin, which could promote ketosis, a state by which the body uses its own fat as fuel. When in ketosis, your body uses up fat stores to give you energy, often resulting in significant weight loss. This is how individuals on “low carb” diets lose weight. Some speculate that Topamax may artificially induce ketosis.
  • Loss of taste sensation: Many people notice that food loses its pleasurable taste and the “yum factor” seems to be missing while medicated. This typically leads people to eat smaller portions and/or less overall food. Some have complained that Topamax makes food taste bland, “grey,” flavorless, and in some cases just “bad.” If your taste buds feel like they’ve been hijacked, it’s a result of the drug.
  • Metabolism changes: While many people don’t believe that Topamax speeds up the metabolism, some do. If you have maintained the same diet pre-drug as during treatment, and aren’t doing anything noticeably different, but are losing weight, it could be a result of a faster metabolism. This theory is less likely to be true due to the fact that this isn’t a psychostimulant medication, but one that should be considered.
  • Saliva production: A specific theory as to why Topamax reduces ability to taste has to do with reduced saliva production. Those that take the drug tend to experience reductions in the amount of saliva produced on a daily basis. When saliva is reduced, it can result in poorer taste and people may lose some of their normal appetite – leading to weight loss.
  • Side effects: Many people experience drug-related side effects that can also contribute to weight gain. Common effects that lead to weight loss include: diarrhea, nausea, and vomiting. If you are experiencing diarrhea and/or vomiting, it’s a no brainer that weight loss is inevitable. If you are nauseous all the time, you probably won’t want to eat as much; this is common sense.

Note: What leads to weight loss in one person may not be the same as in another. Therefore it is important to understand that certain factors may be more influential in one person’s weight loss than another. For example, one person may predominantly experience poorer taste, while another may have a reduced appetite and diarrhea.

Factors that influence weight loss on Topamax

There are other factors that may influence weight fluctuation as a result of Topamax treatment. These include things like: the dosage you ware taking, time span over which you’ve been taking it, your lifestyle and general habits, genetics, as well as other medications that you take.

1. Dosage

It is known that this drug tends to help people lose weight, and there is a relationship between weight loss and the dosage taken. Those that take higher doses, tend to lose more weight than those on lesser doses. It should be speculated that dose in relationship to bodyweight as well as tolerance may also play a role. For a smaller statured individual, less of a dose may produce more weight gain than the same dose in a larger person.

Doctors will generally prescribe specific dosages based on the condition for which you are taking the drug. Those that are on Topamax for seizure prevention are likely to be on a higher dose than those for migraine prevention. The lower the dose, the less physiological influence the drug will have, leading to less weight change. If your goal is to avoid weight loss, you should be taking the “minimal effective dose.”

2. Time Span

The duration over which you’ve been taking Topamax can also play a role in determining how much weight you’ve lost. Someone who has been on the drug for a week and is just adapting to its effects may not experience as much weight change as someone who has taken it for several months. Over the short-term, you’re less likely to notice weight fluctuations in comparison to when you’ve taken it for a few months.

Those that have been on the drug for an extensive period may notice that weight loss stops once tolerance is developed. At a certain point, you’re likely to reach a peak in the amount of weight you lose simply due to the fact that your body will adapt to the drug.

3. Lifestyle / habits

Many people end up losing varying degrees of weight while on Topamax due to lifestyles and habits. Someone who isn’t getting proper sleep, is over-stressed, is eating junk food, and avoiding exercise may not lose as much weight as someone who is doing the opposite.

If you are eating healthy, getting a little bit of exercise each day, are sleeping well, and keeping stress to a minimum, you may be more likely to lose weight. Daily habits account for many individual differences in amount of weight lost while taking this drug.

4. Genetics

While we don’t know exactly how this drug interacts with a person’s genetics, many genetic factors determine how much weight you’re likely to lose in comparison to someone else. Certain people may experience considerable weight loss from this drug, while others may remain weight neutral or even experience weight gain.

These differences in reactions may be partially explained by genetic variation. Fortunately there is new technology in development like GeneSight that predicts how you’ll react to drugs like Topamax.

5. Other drugs

If you are taking other medications, it is important to consider interaction effects as well as how they may influence your weight. For example, if you are on an SSRI or antipsychotic, you may be more likely to eat more food, regardless of how dull Topamax makes your taste buds. Any medications that make you more inclined to eat typically offset the weight loss effects of Topamax.

It should also be mentioned that if you are on stimulant-related medications such as Adderall or Wellbutrin, you may end up experiencing a synergistic weight loss effect. In other words, since you will be on multiple medications that can cause weight loss, the amount of weight you lose will be more significant than if you were just taking Topamax as a standalone treatment.

Should you use Topamax just for weight loss?

Probably not. Obviously this isn’t a medically accepted use of the drug, and most doctors wouldn’t allow it. If you were specifically struggling with weight, they may prescribe Qsymia, which contains Topamax as part of its formulation. Many people that struggle with seizures and are overweight typically are taking the drug primarily for seizure reduction, but may be pleasantly surprised when they also lose weight.

If you are using this drug just to lose weight, it may be difficult to put up with some of the neurological side effects such as memory impairment, dizziness, etc. While some people are willing to take any drug in order to lose weight, you really should be weighing the pros and cons before sacrificing mental performance in order to look skinnier.

Topamax weight loss dosage…

Some research suggests that there is an ideal daily dosage of Topamax specifically for weight loss. Those that consistently take between 100 mg and 200 mg of Topamax daily, have reported that weight loss is virtually effortless. Most people taking the drug within this dose range (assuming they aren’t on other treatments) end up losing between 15% and 20% of their baseline bodyweight. Some speculate that dosages above 200 mg may result in more drastic weight loss.

Will everyone lose weight from taking Topamax?

Not everyone is guaranteed to lose weight on this medication. There is a lot of individual variation such as diet, habits, genetics, other medications, etc. that can have a huge impact on someone’s weight. That said, it is estimated that weight loss is among the most common side effects of the drug Topamax.

Most evidence suggests that weight loss occurs among 11% and 26% of those taking the drug. It should be mentioned that a select number of individuals can experience a counterintuitive reaction of weight gain during their treatment, but this is very uncommon.

Topamax’s therapeutic effect vs. unwanted weight loss

Those that are taking the medication for the purpose of treating a condition like Bipolar disorder may not like the weight loss. If you are already relatively skinny, you may have a problem with looking even skinnier. Although most people look forward to losing weight while on a medication, not everyone shares that perspective. If you are losing a ridiculous amount of weight on this drug and don’t like it, be sure to talk to your doctor about other options and/or Topamax withdrawal.

Also if you like the weight loss, but find the drug ineffective for the primary condition for which it was intended to treat, you’ll likely need to try something new. Others may find the drug effective for treating a condition, and may like the weight loss, but the other side effects such as memory loss may be too profound to justify continued usage. Always evaluate how you’re doing on the drug throughout your treatment.

Did you lose weight while taking Topamax?

If you are a person that has taken Topamax and lost weight, be sure to share your story in the comments section below. It may help others to know the dosage you took, how long you were on the drug, as well as how quickly you noticed the weight loss. Be sure to mention why you think the drug caused you to lose weight (e.g. lost your appetite) and other potential lifestyle factors that may have also contributed to your weight loss.

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{ 61 comments… add one }
  • T.brown September 10, 2015, 10:47 pm

    Yes I took 50 mg of Topamax a few years back and lost 15 lbs in less than 3 months with no diet or exercise because it killed my appetite and made soda taste like crap lol.

    • Jen February 25, 2016, 12:22 am

      Did your taste come back with soda when you stopped taking it?

    • Tara April 22, 2016, 1:08 am

      I swear I’ve heard at least 50 comments saying that soda tastes flat or just bland from the meds. I’ve only been researching this drug for a few hours lol!

      • Tamara September 29, 2016, 10:04 pm

        I’m about to start taking Topamax for my Epilepsy (in combination with my Epival that I’ve been on for 3 years now) and am reading how soda tastes gross…which is totally fine since I don’t drink soda anyways! However I do love food so I hope I don’t lose my appetite too much! But the weight gain (30+ lbs from Epival) is really bugging me (does this every time I go on it) so trying something new…fingers crossed Topamax does a good job!

    • SARA April 29, 2016, 12:05 am

      I used Topamax for years for migraines and went off of it 3 weeks ago. I have ballooned up 12 lbs since stopping, despite a strict diet and working out regularly. I can feel bubbles now… But I have to be honest, I drink diet and I liked it better flat 😄. I’m strongly considering going back on the meds because of my weight…

      • Bree October 19, 2016, 12:23 pm

        The second time I went on topamax I had no weight loss effect. Also the third time.

  • Omelas September 11, 2015, 9:56 pm

    I am a sedentary middle-aged female office worker. When my neurologist put me on Topamax for my migraines many years ago, I weighed 164 lbs eating two tiny meals a day, and I would put on a pound if I even went out to dinner on the weekend. Then, once I put on a pound, I could never get it off. I was miserable.

    Once I was on the Topamax (100 mg bid), I did not exercise one tiny bit more, or eat one tiny bit less. I certainly did not forget to eat, or any of the bizarre theories above. Food tasted great, except for the first two months or so soda tasted awful. But the weight just melted off me without my changing a thing. I got down to 145 lbs, and then I realized that I could stop starving myself. I now eat a healthy small breakfast, lunch, and dinner, weigh 155, can have an occasional dessert or sweet, and my neurologist will take me off Topamax when he pries it out of my cold dead hand :) (it also works really well for my migraines)

  • r.s. October 24, 2015, 4:53 pm

    I learned of it from coworkers. I’m seeing a doctor who also prescribed wellbutrin and phentermine (don’t get confused with the similar sounding med from past that was discontinued) and use 50mg topamax in afternoon. I’m very happy. I’m a 52 year old, female, office worker and last time I weighed 150, I was running 20 miles a week. My back and feet can’t handle that anymore (12 yrs ago) and honestly I don’t eat poorly, no sodas ever, maybe 1 month. Egg toast, apple, salad, yogurt, walk 30 min at lunch, few crackers mid day, home, chicken and veggies.

    Heck half a hamburger fills me up. Cursed slow metabolism. I got you now! So nice to wear clothing that isn’t tight. My back is happier too. Also I’m athletic and love going to gym in early mornings for an hour doing cardio and weights. But still a struggle. Free at last! This is the way it should be. Watch what you eat and exercise and the weight falls off. I’m all 5’4″.

  • Dene November 15, 2015, 3:55 am

    I used to get migraines everyday. I was also 100+lbs overweight. My doctor suggested Topamax for my migraines and told me I might lose weight as a side effect. The pros: I lost 20lbs within 2 months (I couldn’t drink any sort of carbonated drink because I could only taste the carbonation, I no longer had cravings, and I lost my appetite) and my migraines disappeared altogether (including up to two years after I got off the medication.) The cons: I stopped taking it after 3 months because I began experiencing numbness and tingling in my legs, arms and face. I also experienced vertigo on occasion (usually in the evenings) and I couldn’t deal with the fuzzyheadedness.

    • Sherry September 4, 2016, 10:07 pm

      Hey Dene what was your dosage??

  • Christine November 25, 2015, 12:10 pm

    I’ve been on Trokendi XR 50mg for about 5 wks now, prescribed for chronic migraines. I’m not sure how much Topamax this contains just yet (50mg?)I also take 300mg wellbutrin for bipolar disorder. I noticed a loss of appetite immediately. I’ve lost approx 8 lbs in 5 wks! I’m not complaining. My food still has great taste, and I just craved a grape soda, ended up with orange soda but it was great!

    My food choices haven’t changed, maybe the frequency and portions. When I first switched to wellbutrin from prozac 2 yrs ago, I lost about 20lbs in a few mos but in no time gained that back. I have noticed some intermittent tingling, twice in my feet, once in m hands. I’m not sure if this is anything to worry about. I may have a lil weaker stomach in the mornings, that usually goes away.

    This could also be caused by the intro of new vitamins. Not sure. I take this topamax product with 400mg vitamin B2 for the daily headaches, they are fewer and less intense but not gone. Again its only been 5 wk on this treatment, only adding the vitamins a couple weeks ago. I am 52/fem/5’5/200#.

  • Crystal November 29, 2015, 9:37 pm

    I’ve been on topamax for 2 months now and I have lost 21 lbs. I feel fantastic! I did have some sluggishness the first week but have adapted well. I can no longer eat sugar or soda as they taste terrible, but I think that helps with the weight loss considerably.

  • Martha December 9, 2015, 3:49 am

    I started Topamax a little over a week ago. The side effects have been quite the trip but my headaches are a joke compared to the migraines I lived with on a daily basis. Today is Day 9 and I’m on 50mg, I’ve lost a little over 5 pounds since I’ve started, doesn’t seem healthy but it’s not as bad as some of the other side effects, they do seem to be diminishing as I was told they would so I’ll see where it goes.

    I started on 25mg and just increased to 50mg 4 days ago. I really just don’t get hungry anymore, soda tastes like poop… I didn’t believe it would lol… even when I am hungry the thought of eating food doesn’t seem appealing…

  • Smita prakash December 20, 2015, 2:12 am

    I have been taking topamax for the past 20 days, and yes, I have lost 5 kgs, but I see no difference in my eating habits or in my appetite. I am the same and my taste buds are no different. I only have a little tingling in my feet, but that’s all – no other side effects.

  • Wendy December 30, 2015, 6:41 am

    I’ve been in Topamax for 3weeks now and lost 8lbs. I wasn’t sure what to expect. I was told it would be an appetite suppressant but I still have the same urges as before. The difference is that I can control whether or not I act on them and what whether I eat a quick junk food snack for a healthy one. I was losing weight but hit a plateau and this seems to have jump started me again. I’m truly grateful to my Dr for putting me on this.

  • Derryn December 30, 2015, 8:56 pm

    I am 64…hurrah…mistaken for early 50’s…because I watch my skin and weight!!!! Hurrah too for Topomax! Dropped low and MD had a fit, but great for migraines and back on 100 mg bid. However, you do build up a tolerance. So I have an empty refrigerator besides eggbeaters and lean chicken breasts. Unlucky me, it’s what I have to do. Bottom line… great help for weight. Side effects diminish.

  • Leslie December 31, 2015, 12:49 am

    I am currently on 150mg of Topiramate…50 in the morning and 100 at night. I am 49 and have seen no weight loss. It has lessened my appetite considerably. Will I see weight loss eventually? It’s been about 3 months, maybe 4.

    • Nina May 4, 2016, 3:05 am

      I was on the same dosage & now they up my dosage too 100 in the morning & 100 at night & I have not seen any results at all. I have ate healthier & I work out once a week. I need to be working out more but just don’t. So who knows if it will work or not.

  • carey January 5, 2016, 7:18 pm

    I just started taking for my migraines due to trying other meds with no success and I started low carb diet as well in November. My neurologist said it would make me lose weight as well and help with my headaches… It has REALLY helped with my migraines and in the 3 weeks I have tried Topamax I have lost an additional 6 pounds! I am not complaining!

  • Tawny January 26, 2016, 11:14 am

    I have been on topomax for severe migraines for just over a week and have already lost 4 lbs. I am 5’2″ was 129 and am now 124. I was diagnosed with occipital neuralgia and migraines so I had a nerve block along with the topomax and have been completely headache free since. My only complaint is my bowel movements UGH and I feel like I am drinking Nyquil all day.

    I am so drowsy during the day so I am sleeping a lot (I am on leave from work) and that causes me to have insomnia at night. I sure hope this phase lasts. I am worried about the weight loss because I just worked on putting back in weight. I got down to 115 and everyone started freaking out calling me anorexic (completely not the case).

    However I have noticed that I just have not been hungry lately at all. I also have noticed that I am jumping from thought to thought which is maybe another reason I can’t sleep.

    • marcottas August 19, 2016, 5:07 pm

      Hello Tawny, I’m curious, I am a 29 yrs old with short-lasting unilateral neuralgiform headaches with cranial autonomic features (SUNA) which is similar to occipital neuralgia with a much more complex title; I have been off work for a year now and on topiramate and lamotrigine.

      I have lost 32 lbs so far, the side effects were horrible at first but I tolerate them now except the whole short term memory of a goldfish thing (I take high doses) things have got much better but my neurologist has recommended an occipital nerve block as an hail mary before I’m send back to work (my insurance company is quite insistent) do you have to go back often? Was it a one time thing for you and it gave you permanent relief?

  • Meranda January 28, 2016, 10:46 pm

    I started topamax/topiramate on January 15th for chronic headaches and cluster seizures. I also got diagnosed with fibromyalgia. I’m a 23 year old female. I am over weight. This medication has helped my headaches stop. I am have had a few seizures but not like I was. They have not been has bad. I know this is mainly about the weight loss so I’ll get to that.

    I started it on the 15th weighing at 260 lbs. I am 5’7″ so I am very overweight. I weighed myself on the 26th and had gone down to 252-253 lbs. I know you lose more the bigger you are. I started out on the way you are supposed to. 25 mg in the morning 25 mg at night and then double that after a week and then triple it and then get up to the dose my doc wants me at.

    I will be at 100 mg in the morning and 100 mg at night by the 5th of Feb. I have noticed the other side effects as well. Dizzy, bad tastes, nothing tastes good, bad memory and some aggression issues as of late. But I am giving it a chance and am going to see how this works and let my doc know. Good vibes to all you and your families.

  • Lana January 29, 2016, 3:56 pm

    When I started Topamax at 100 mg b.i.d., I was 170 lbs. After one month my doctor added Wellbutrin XL 300mg. I am a 49 y.o. female and 5’6″, sedentary job. With adding a healthy diet and one 30 min walk 3 times a week (outdoors), in lost 35 lbs in 4 months. Now it is almost 2 years later, and I regained only 5 lbs. Now I eat everything I want.

    • Piper March 6, 2016, 4:31 am

      Be careful Lana. I am 45, and your same height. I weighed 250 and lost 60lbs on 200mgs b.i.d. and a low-carb diet three years ago. I was happy as a clam. I stayed at 190 eating relatively healthy for a year and a half and then started to eat everything I wanted. I brought all those carbs I loved so much back into my life and even beer too.

      Within a year I was back up to 225 and depressed as all hell. So on December 30th, at 222lbs, I started back on Topomax (at 50mg and now at 200mg again) plus I added Wellbutrin (started at 150mg and now at 300mg). Today, I’m at 188, which is 34lbs down. I’m headed to 150 and then maybe even down to 135. At that point I’m going to have tuck surgery to handle my skin that will most likely be a problem after 115lbs of weight loss.

      I credit Topomax and low-carb dieting for my success and am so thankful I found them both. I just wanted to warn you away from the eating everything you want now. It will catch up to you, I promise. Don’t let it fool you! Be vigilant!

  • Mary February 9, 2016, 10:51 pm

    I have been on 400mg of Topamax for 3 years now. Originally lost 78 pounds and have gained back 50. Migraines are all but gone. That was the primary goal of T. Success. I am a happy camper.

  • Carol Green February 18, 2016, 8:28 pm

    I’ve been taking these tablets for migraines and they are very effective in stopping them. Just recently the migraines have come back and now I’ve been asked to go from 50mg to 100mg slowly in a month. Not sure about weight loss, but no other side effects.

  • Piper March 6, 2016, 4:50 am

    I’m a two-time Topamax taker and an absolute believer in it’s effectiveness as a weight loss aid. It has been prescribed to me as a mood stabilizer and it does its job by relieving my depression when it helps me lose weight! Three years ago it kick-started my efforts to lose at least 100 pounds and I shed 60 pounds in six months without exercising at all (then I stayed there for a year and a half before I spent a little over a year gaining half of it back – so I got back on Topamax and spent the last two months losing the 30lbs again!).

    I did follow a low-carb diet and eliminated beer from my diet because carbonated beverages tasted horrible once I started taking Topamax, but I think it’s primary mechanism wasn’t appetite suppression but craving curbing/willpower boosting/simply strengthening my ability to say “nah, I’m good” where before I would just crumble and eat. Weeks before I was on Topamax I would joke that I couldn’t turn away an offer of food even though I didn’t want it and knew I didn’t need it.

    With Topamax, it’s easy to pass food up, refuse it, to even sit next to people eating my FAVORITE foods and not be upset about not getting to have any myself. It’s the strangest thing! My motto “Nothing tastes as good as skinny feels” actually means something now. Now, I get to finally exercise because my body is a size that I can do that. I’m so excited to be able to add exercise to my healthy lifestyle now. It hurts, but I can actually DO it.

    It’s like a whole new world and I love it! Topamax has made this all possible for me. Sure, the side effect of not being able to put sentences together quickly like I used to be able to kinda drives me nuts sometimes but being a ditz is well worth being thin, I promise you. I see why they call it the supermodel drug: it makes you dumb and skinny! LOL.

  • Toni March 20, 2016, 1:25 pm

    I went on Topamax mostly for migraines but because I am also overweight my doc suggested we try Topamax for it. I was terrified to take it with all the negative side effects. But I was only prescribed 25mg so I thought why not? After the first day, I was like… Ok, no bad side effects, but food still tastes delicious and I’m still hungry. My appetite has changed not even a little. But I haven’t had a headache and I still have managed to lose 10 lbs. in 4 days. Definitely glad I ignored the crazy stories and took it anyway!

  • Maxine April 5, 2016, 5:22 am

    Have been on Topamax for several years at varying doses for migraines but currently 150mg. Started at a little over 260lbs have lost close to 80lbs. I don’t believe all the weight loss was due to drug as I have ulcerative-colitis and I was also trying to lose weight but I believe it has helped. Not necessarily in pleasant ways always.

    Taste perversion, mental fog, memory issues, nausea less pleasant assistance. Appetite suppression and less cravings helpful and potentially due to the medication also. As much as I hate the issues I am having, my Doctors are recommending I stay on it until all the weight I need to lose is off. I have struggled for so many years and this is my first major success since my early twenties.

    Now that I have ulcerative-colitis and arthritis (and pre-diabetic) losing the extra pounds are critical, no going back.

  • Mia April 9, 2016, 2:31 am

    This is an extremely informative article, and probably the only one without bias that I have seen. I am 5’9″ and 194 lbs (I used to be 220, which put my BMI into the “obese” category). I was recently prescribed Topamax for binge eating and to help with weight loss but wasn’t quite sure how it worked or what the side effects were. I will be sure to update my results. Thank you for such a great piece.

    • Toni October 5, 2016, 2:14 am

      How has it been going? I am around the same height and weight and started on 25 mg and lost no weight so upped to 100 mg to see if it would change.

  • Kin April 29, 2016, 12:38 am

    At the time of this entry I have been taking Topamax for approximately 9 months. I started taking Topamax 25mg (AM) and 50mg (PM) for migraines about a month prior to discontinuing Zoloft. I had been titrating down from Zoloft 100MG per day. I had started taking Adderall 5mg (2xday), after being diagnosed with Adult ADD, a few months prior to beginning Topamax.

    When I started Topamax my physician increased the Adderall dowager to 10mg (2xday). My Topamax dosage has since been increased to 50mg(AM) and 100mg (PM). Prior to starting the initial dose of Topamax, I was experiencing migraines 3-4 per week, decreased to 3-5 per month. Since the last dosage increase, I am averaging 1-2 migraines per month.

    Side effects:
    * Numbness and tingling in feet and hands for the first 6-8 weeks of taking Topamax. While this was annoying and somewhat worrisome in the early stages, it eventually subsided.
    * Drowsiness – when taken in combination with Requip 4MG. (Not a bad thing, since RLS is terrible for me. Helps me get a decent night of sleep.)
    * Weight loss – I cannot honestly say that I can contribute my 40 pounds lost, and I am continuing to lose, all to Topamax. The drug may have helped. I think discontinued use of Zoloft, along with the combination of Topamax & Adderall have played a major role.
    * Appetite suppression/change/nausea-I have always been a breakfast person, hungry first thing in the morning. Now, I feel nauseous in the mornings and it’s closers to noon before I feel like eating. Therefore, my eating habits have changed. I have started having protein shakes, smoothies, or meal replacement shakes and taking vitamin supplements.

    I love the benefit of not suffering from migraines! Getting through the temporary numbness/tingling was worth it. If the combo of Topamax & Adderall continue to help me with my weight-loss, that’s awesome too. I am diabetic, so every little bit of weight I lose is helping me get closer to getting off medication to control blood glucose levels.

  • alayna April 29, 2016, 1:31 am

    I am on topamax as a weight loss supplement and am very tired during the day. My doctor gave it to me to help me not drink the soda. That is definitely working but my question is… would I be able to take this at night and get the same result so I’m not so sleepy during the day? I have a 6 month old and don’t want to be tired all day while playing with him!

    • Laina August 6, 2016, 3:41 pm

      Yes.

  • mary April 29, 2016, 8:07 pm

    I’m not really sure if it’s related to the Topamax or not, but I do take Topamax. I have lost 100 and 79 pounds in 18 months. I just honestly couldn’t tell you when I started taking the topamax to know if it is related to the weight loss.

  • melissa reynolds May 3, 2016, 3:18 am

    I lost almost 30lbs on it. Lost cravings for a lot of things… soda was ick – tasted flat at first when it hit the back of my tongue. It was like acid going down. I haven’t had soda since December.

    • Samantha November 21, 2016, 10:38 pm

      Exactly like acid!

  • CC May 5, 2016, 10:43 pm

    I have been on Trokendi for 4 weeks now. It’s in combination with phentermine for weight loss. 6’4″ 341.2 lbs. I was taking 100 mg at first, but now 25 mg. The tingling in hands and feet is there daily, 16.8 lbs lost so far in 4 weeks, the taste of sweets/candy is gone (I tried and I am repulsed). I rarely eat meat now, the thought of it and the taste of it is disgusting, which is crazy to me.

    Only veggies & fruit are tolerated without being disgusted. Jamba Juice knows me very well now, lol, as I frequent them to get drinks. I stay dehydrated daily, and drink a gallon of water daily (and still feel dried out). I will try coconut oil to work on this. I have a lot of brain fog moments, but I sleep so peacefully during the night than ever before.

    I take it at night with metformin, and I wake up early, fully refreshed and ready to move around! The good definitely outweighs the bad for me, so I won’t complain much.

  • Heather May 6, 2016, 4:40 pm

    I was put on this medication for migraines and at first noticed a reduction in my appetite. Not long later I started botox injections every 12 weeks and my appetite returned and I started to put on weight much to my dismay. So with my Dr’s ok I increased the topamax as I was getting breakthrough migraines and noticed my appetite decreasing. Then increased the dose a little more and rapidly lost weight.

    I dropped 4 inches off my waist within a week had a lot more energy. Felt alive and alert and way more happier than I have been in years and no migraines. I’m eating well though a lot less – and rarely any junk food. Not because of my concern of weight gain – more for the fact I have issues with my gut and need to watch what I eat. Wish I’d come across this drug years ago.

  • YerkesDodsonCurve May 19, 2016, 8:18 am

    This medication has been miraculous but you must understand that it’s not a panacea. YOU have to be ready to use it properly for weight loss and understand how it works. It appears to target the addiction/pleasure/opiate receptors in your brain. These same receptors are targeted by the (evil) Food Scientists who combine Fat/Salt/Sugar in specific ratios so that you feel the need to overeat their products.

    Because why else put sugar in french fries? Why else put sodium (salt) in coca cola? So, BE READY when you do this: This means, stop eating fast food. Stop eating crap from chain restaurants. Drink only water and stop eating sugary junk. This medication makes you just simply NOT CARE about eating that stuff – for a period of time.

    It buys you TIME TO CHANGE YOU HABITS – so you’d damn well be ready to change them. I decided to just eat things I’d never eaten before. I ate a can of refried beans for dinner yesterday. I hate salad (salad makes me sad. it’s so dull) but I ate one for dinner last night. I learned to eat for fuel. My MD told me “eat the Mediterranean diet. Eat about 1100 calories and make them count. Oh and try to move your body every day.”

    I’m 55. I started at 215 pounds. That was in September. It’s May and I’m at 162. He wants me at about 135. I’m going to go for it. It’s not easy. Because this stuff doesn’t just Keep Working. You have to realize that eventually you habituate to it. So, think about how you are going to re-wire your habits before you Go For It.

    I drink Odwalla protein drinks because I’m not the kind to prepare anything. This means I don’t have to use the stupid blender. I have a bag of pistachios at my desk. And a jar of cashew butter. Lunch is sometimes 2 spoonfuls of cashew butter between appointments. And drink and drink and drink water. Make yourself order the soup, not the burger. And no more soda. Buh Bye. RE-WIRE YOUR BRAIN.

    Brains are plastic, man. They truly can be re-wired via habit change. You can do this and Topamax can help but it can’t do your work for you. My friend a neuropsychologist calls Topamax “Dopamax.” I told her I did not care one Whit about that. I am a psychologist too. I have brain cells enough to get through. I am just happy that 50 pounds are gone and that my knees don’t hurt. My blood pressure is down and my cholesterol is down too. But you have to plan and prepare.

    You also have to be ready for your friends and family to act weird when you do lose weight (they will). Demand that your physician provide you a medication combination that works for you, and you demand of yourself a plan that you can follow. Interestingly, watch what happens when you allow yourself, a few weeks into healthy eating, to eat something that has the “evil magic combination” of Fat/Salt/Sugar – like those fries/coca cola/ice cream from one of those fast food places.

    I went off Topamax for about two days. I had a bite of fries and a drink of coke. And waited. Then, POW – there it was – this INTENSE CRAVING for more of that coke and fries. It was amazing and fascinating and I was furious at the fact that corporations manipulate my brain – and yours – for big profit. It was a great lesson. That’s the advantage of being a psychologist I guess. At least I was ready for it and knew what it was when it hit.

    It was all I could do to walk away from those fries and coke (which was poured down the drain). I have to tell you, use Topamax to help you CHANGE YOU HABITS. Use it to educate yourself about the way your brain chemistry works. YOU have to work your brain, using the medication. Don’t just take the medication and sit back and think you can be a size 2. CHANGE YOU BRAIN! And good luck!

    • NCS September 28, 2016, 2:49 am

      That was fantastic advice and so helpful. Thank you.

      • Laura October 8, 2016, 6:34 pm

        Thank! You!

  • TH May 23, 2016, 2:38 am

    I have been taking topamax 25mg in the morning and 50mg at night for approximately one year for migraines. I have lost 52 pounds. Food is no longer my main focus. Lol. My tastes have changed. Diet drinks taste horrible and I have very little cravings for sweets. I needed to lose this weight but now I’m doing my best not to lose any more (never thought I’d ever say that)!!!

  • Marilena May 24, 2016, 3:51 am

    I started taking Topiramate in November, weaned into 100mg in combination with 150mg Wellbutrin, both for anxiety, SAD, bipolar and compulsive behaviour (including eating habits). At 5’6′ and 180lbs I was overweight and that bothered me, I tried fad diets without success only contributing to my anxiety. Topamax was a crucial in curbing mu appetite, controlling the cravings, as someone mentioned above, just gives you the ability to say “no thanks”.

    Now I only will have a dessert if it’s really worth the calories. I could probably up my exercise but I’m going for the lifetime change here, not another fad. So sustainable couple times per week walks is what I’m able to do. The results: 6 months in I lost 30 lbs, I’m now at 150mg Topiramate and 300mg Wellbutrin.

    I don’t really feel any side effects anymore other than the flat soda (but I don’t drink soda) just used to drink Perrier and that tastes awful, so saving that penny. I felt slightly tired at first, not anymore. Maybe a bit constipated. And the tingly sensation on fingers and toes, but that has lessen too.

    All in all a great med combination. I hope I don’t develop a tolerance and it loses its potency because I feel great.

  • Alex June 15, 2016, 7:44 pm

    I was started on topiramate for migraines last June started on 25mg twice a day quickly increased to 50mg twice a day. I was already fairly in shape but wanted to lose a bit of weight, I didn’t go to the gym much, had a pretty bad diet. I’m now on 100mg twice a day. I haven’t noticed any change in appetite but I’ve definitely lost weight probably a few kilo grand without any exercise or change in diet.

    Makes me wonder if there is some change in metabolism involved. I do feel like my memory is pretty rubbish though but it was like this before I started on topiramate and I was told it was a symptom of migraines rather than the treatments.

  • misty August 1, 2016, 3:05 pm

    I started on Topamax 25mg 5 weeks ago and lost 6 pounds. I am now at 50mg and don’t know what I have lost since the increase. I don’t know if I can say Topamax is completely the cause of the loss because I am also taking Welbutrin 450mg as well as 36mg of Concerta for adult ADD and 2000 mg of Metformin. But the weight really started to come off when topamax was added for bi-polar.

  • Marie August 5, 2016, 7:51 pm

    Hi. I was put on Topamax after gaining weight on Gabapentin for pain from shingles. I’ve tapered up to taking 100mg. now twice a day. I started out at 220 lbs. I’m now at 140 lbs. it’s been almost two years. Quite a significant loss. I’m 5’7″ so I don’t need to get any thinner, but I’ll admit that I like the loss at this point.

    For me the side effect was to lose any desire for sweets. Not so much the desire, but the follow through. I’d think I’d want a nice piece of chocolate, but when I’d go to buy it the smell of it or even the thought of going to get it was a turn off. Never have I ever turned down a piece of great chocolate! I eat maybe a quarter of a bagel for breakfast and that’s it.

    I forget to eat lunch unless I’m with someone and I look like I’m anorexic so they give me “the eye” and bake me eat. Then I’ll eat with my family something at dinner, but honestly I’m not hungry. I try to cook things I know I used to love just to smell them and trigger my hunger. Sometimes it works. Mostly, just the cooking seems to satisfy me and I’m not hungry by the time the meals served.

    So that’s my story. Hope this helps someone.

  • KM August 20, 2016, 11:46 pm

    I started Topamax 25mg BID, July 8 prescribed for quick weight loss (I’m looking at back surgery). Without effort I’m down 20 lbs in 7 weeks. I have no desire to eat. I force myself to do so because without the calories I know I will feel like dog pooh. When I first started taking the drug, we were traveling in upstate NY. I live in CA.

    We stopped for a soda and I ordered a diet coke. It tasted like soap. I switched to water. The next stop I ordered a diet coke. Same thing. The whole trip, every diet coke tasted like liquid soap. I told my husband NY mucked with the recipe and I would be writing a letter to corporate as soon as we got home. Only when we got home the diet cokes there tasted like soap, too. I finally figured out it was the meds. LOL.

  • Kelly August 22, 2016, 9:20 pm

    I’m on day 8 of only 25mg of Topamax in the mornings, and I’ve to work up to 50mg in the morning and 50mg in the evening. I’m 30, and have lost 5lb this week alone on this dose and was already a healthy weight so it does work for weight loss – it really does make you not want to eat.

    What I am struggling with is closed-eye hallucinations when I try to sleep and too much energy that doesn’t allow me to switch off – I seem to have the opposite effects to other people! I am being treated for MS related headaches/Trigeminal neuralgia type facial pain

  • Heather September 11, 2016, 2:26 am

    I have been off and on topamax now for 4 years… when I first started taking for my migraines I was 120 not trying to lose any weight! I dropped down to 88lbs in 3 months or less… I still ate anything I wanted and I would still wake up the next morning having lost a pound or two a day!!! Once my system got used to the medicine I didn’t lose anymore weight!! Sodas do not have a taste at all is the only down side!!! It works awesome for my migraines!!

  • Elton September 30, 2016, 5:14 pm

    For three week I’ve taken Topiramate for constants headaches; and yes I have lost eight pounds. I do workout on the boxing bag and some weight training.

  • Anna October 7, 2016, 11:53 pm

    It can work at a very low dose with little side effects. I’m taking only 25 mg at bedtime for lithium-induced weight gain and lost 8 lbs in 1 month so far (female, baseline weight 150 lbs). I get slight tingling and dizziness after I take it, but I fall asleep soon after so it doesn’t bother me. No word-finding problems or other cognitive issues. Mostly it just decreases my interest in food — I eat about half of what I used to.

    The decrease in appetite kicked in on day 5. I took 200 mg years ago for headaches, and I wouldn’t recommend it — side effects were awful. So, I’d recommend starting low, and waiting at least a week or two to see if it’s doing anything before increasing the dose.

  • Jodi Gilbert October 15, 2016, 4:32 am

    I have slowly been tapering up from 25mg now on 75 on my way to 100mg I believe. I am trying it for weight loss from Lyrica I took for fibromyalgia and gained 40 lbs. So far no luck. I have been on it for 3 weeks and have been working out. It does curb my appetite, so I have been eating less but no weight loss. Bummed. I’m hoping it begins to work soon. I have never been this much over weight!!!!

  • Eleasha October 28, 2016, 7:46 pm

    Hi! I am 39 years old and I am on both Wellbutrin (450mg in the morning) and Topamax(50 mg morning & night) I was prescribed these meds for migraines and Military Sexual Trauma (M.S.T.) I have been on Wellbutrin for 5 months and Topamax for 3 months. Yes, Wellbutrin helps a little with appetite but I didn’t notice anything major. I did have a baby in February, my last and I ate until I was content! I do work out, I did notice more of a decrease when Topamax was added. I also do cut back, but I think the assists with the cravings:) I love, love sweets!!!

  • Christina October 29, 2016, 10:14 am

    I took Topamax for 2 months for migraines. Never got above 50 – 75 mg. Still had headaches, although not so severe that I had to leave work 3 times per week (the only positive to this shit). Otherwise, I lost my appetite, and lost 12 – 14 lbs within 6 weeks. I could see the bones in my chest and I wanted to eat, but if I ate more than a pack of crackers or a yogurt, my stomach would give me a fit. I would be constipated for days at a time but whenever I actually could use the bathroom, I had diarrhea.

    I would wake up in the middle of the night with stomach pain and nausea, and got random nosebleeds (never previously had a nosebleed). I didn’t want to commit suicide but I was extremely depressed and would always think about dying and ways to die (I have had severe depressive periods before, they are so random and unpredictable it’s hard to keep track, so I may already have some sort of disorder, so this stuff either triggered it, or caused it – hard to tell). I had no energy, but couldn’t sleep more than 3 – 5 hours. Best part of this medicine: I got so dumb I could hardly stand myself.

    I would forget words and mix them up (e.g. “five dollars total is your even”), I’d ask the same question 3 times in a row, I couldn’t stay focused, finish a thought, or figure anything out. When I started topamax, I weighed 154 (f, 5’7″). I exercised 6 days per week, no soda, caffeine, limited sweets, breads, etc. No other meds except for occasional pain relievers. Perfectly healthy except for frequent migraines.

    After 2 months I weighed only 140 and felt miserable and disgusting. I began using a Cefaly device and tapering off the medicine. First of all, using Cefaly made me realize how poorly Topamax actually helps migraines. Second of all, my side effects wore off to a point, and then stopped improving. I have been off the medicine for almost 6 months and still don’t have much of an appetite and cannot tolerate a lot of foods that never bothered me before.

    Still having bad GI problems that I never had before starting the medicine (this was one of the worst side effects and is my biggest remaining problem). This one doesn’t bother me so much, but just as an example of how the side effects have not worn off, I still am not sleeping much. So, before taking Topamax, ask yourself if whatever “cure” your might benefit from it is worth potentially messing up everything else in your body, and if you are willing to live with severe and potentially permanent side effects.

    Do some research on how this stuff actually “works.” I wish I had listened to the internet instead of my neurologist.

  • Kristin November 6, 2016, 4:47 am

    When I was 21, I was put on Depakote and gained a lot of weight. I went up to 170 pounds. I was hungry all the time! I was taken off it and put on Topamax. My hunger vanished. In three months I dropped to 102 pounds. Yes, 170 to 102, with no exercise. I just stopped eating (medical anorexia; I wasn’t hungry). I was hospitalized and weaned off Topamax.

    I’m 32 now and up to 198 pounds. I’m dealing with migraines so I’m back on Topamax. I just restarted it three days ago and my appetite has already decreased. Things taste odd (metallic, strange, just “bad”) and I’m having to remind myself to eat regular meals.

  • Samantha November 21, 2016, 10:26 pm

    Soda literally burns my mouth. It almost hurts to drink. If you have ever had soda with too much carbonation to it…times that by 10. It is horrible. Good way to help you drop soda from your diet.

  • Cora Regina November 22, 2016, 11:34 pm

    How on earth is this working for all of you? I feel like I’m literally the only person in the world this stuff doesn’t work on. I used to be 5’4″ and 140 and then suddenly ballooned up to 220 with no changed in diet or exercise habits without any explanation over the course of two years.

    I’m now on 150mg of Topamax and working my way up to 200, have worked up to that dose over the course of several weeks, am in the gym several times a week with my trainer, neurotically watch what I eat… and haven’t lost a single ounce. None of this magical “I’ve been on it for ten days and have already lost six pounds!” stuff here, I literally haven’t lost one. single. ounce. Just a lot of money paying for the pills, and I’m getting more and more depressed as each day goes by.

    • Kate December 2, 2016, 7:46 am

      Are you taking it for weight loss alone? If so, perhaps your physician might consider prescribing Phentermine as an adjunct to the topamax. They have a synergistic effect when it comes to weight loss, and tend to be very successful. Another thing to consider is that you may not have reached the dosing threshold necessary to start losing weight at the time you posted this comment. How are you doing now? Better I hope. Either way, I’d like to know – I am a pretty decent listener, and can ever be a bit witty every now and then. 😉

  • Haley Hoile December 1, 2016, 5:07 pm

    I’ve been taking Topamax 50 mg for about a month and I quick taking it and now I started taking it again. I’ve lost weight and some bad side effects are going on. My dad worries and I’m on 14 and in 9th grade. I’ve lost 5 pounds or more so far. I barely eat anything or crave anything anymore. Let’s see how it goes. But I like it because I’m 20 pounds overweight and it’s working.

  • Kate December 2, 2016, 7:03 am

    I have been taking topamax for several years now – I’d say about four. I take it for generalized tonic-clonic seizures, that developed with no warning. The dose I take is 200 mg bid (twice daily). When I started I weighed about 180 pounds (I’m 5’4″). After 3 months, I was down to 113. I did nothing to alter my lifestyle – no new diet or exercise routine.

    It should be noted that I do have to occasionally walk/bike when I can’t find a driver, because I’m not allowed to drive anymore due to the occasional break-through seizure. Other than that, I did nothing to merit losing so much weight. Topamax has been outstanding at controlling my seizures, when a lot of other medications either utterly failed, had intolerable side effects (vomiting, vertigo, soul-crushing depression,) or I ended up having an allergic reaction.

    The only other side effects I have had are some mild numbness/tingling in my hands when I first started, and a headache that was easily treated with some naproxen and increasing my H2O intake. The weight loss has since leveled off and I have yet to regain any of what I lost. All of this has come with a very steep price: in addition to losing any hope of ever being able to drive again, I will probably never be able to work again.

    I have tried, but I have numerous partial-complex seizures that play hell on the old short term memory. Employers don’t like that at all, especially in the field I worked in: healthcare as a medical assistant. Yeah, when you have 20 different things going on, and blank out for 10 seconds, which leads to you not documenting a phone call, that’s BAD.

    So, did I lose a shit-ton of weight in very little time with no effort? Yep! Would I gain it all back if it meant that I could have my old life back? Yep! Don’t get me wrong, I’m not chilling in a pity pot crying about how much life sucks. I live in America! I’m lucky as sh-t! At the very least, I can go on disability, food stamps, etc. I did try less demanding jobs, like cashier at Target, but even that was too much.

    However, I will still try to supplement my disability income by doing some portraiture, and doing volunteer work for the social aspect. As a medical assistant I worked in neurology (yay for irony!!!!!) and as an observation, not a scientific fact, so, please don’t take this as gospel, I noticed that the patients who were prescribed topamax as an anticonvulsant would tend to have more drastic results with weight loss than those who were prescribed it for migraines. For one, migraine patients would only take between 50-100mg twice daily, whereas someone with epilepsy takes as total daily dose of 400 mg a day.

    Also, the migraine patients were a lot more likely to be noncompliant because during titration, you often develop headaches as your body adjusts to the medication. Optic neuralgia (pain around – usually at the top- of the eyeball) is commonly reported. Since you are talking pills to stop headaches and they are causing new and very different ones, well duh! Of course people stop taking them.

    My point is this: yes absolutely topamax does work to cause a lot of people to lose weight, and does absolutely zilch in terms of weight loss or gain in others. Some people lose weight with no effort, some with a little effort, some with a lot and so on… Some people have no side effects, all the way up to “OMG, these pills were manufactured in Dante’s 9th circle, and must contain Satan’s toenail clippings as the main ingredient, because I’ve never felt so horrible – by all you hold sacred, dissolve these things in a vat of acid or the apocalypse will start for the LOVE OF GOD DO IT NOW!!!!”.

    We want absolutes, black and white answers, especially in the world of healthcare. But remember, physicians PRACTICE medicine, they haven’t perfected it.

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