From the Guidelines
For a 55-year-old female taking Concerta and Mounjaro for weight loss, I strongly recommend adding phentermine to her treatment regimen, as it has been shown to be effective in promoting weight loss when used in conjunction with lifestyle modifications, according to the most recent guidelines 1.
Key Considerations
- Phentermine is an adrenergic agonist that activates the sympathetic nervous system, leading to increased resting energy expenditure and appetite suppression, as noted in a study published in Clinical Gastroenterology and Hepatology 1.
- The recommended dosage of phentermine is 15–37.5 mg orally once daily, with the option to individualize the dose to achieve adequate response with the lowest effective dose, as outlined in the same study 1.
- It is essential to monitor for medication side effects, particularly since Concerta (methylphenidate) can suppress appetite and Mounjaro (tirzepatide) affects glucose metabolism and digestion, as highlighted in a review of pharmacotherapy for obesity 1.
Lifestyle Modifications
- Regular physical activity, aiming for 150 minutes of moderate exercise weekly, is crucial for sustainable weight loss, as emphasized in the AGA clinical practice guideline on pharmacological interventions for adults with obesity 1.
- A balanced diet focused on protein and fiber, adequate hydration (at least 64 oz of water daily), and consistent sleep (7-8 hours nightly) are also vital components of a comprehensive weight management plan, as noted in the same guideline 1.
- Adding strength training 2-3 times weekly can help preserve muscle mass during weight loss, which is essential for maintaining metabolic health, as discussed in a review of lifestyle interventions for obesity 1.
Additional Recommendations
- Regular medical follow-ups are necessary to adjust medications as needed and monitor for potential side effects, as emphasized in the guideline on pharmacological interventions for adults with obesity 1.
- Keeping a daily food journal can help identify eating patterns and triggers, allowing for more targeted interventions, as suggested in a review of behavioral therapies for obesity 1.
- Supplementation with a multivitamin may be beneficial, but should be discussed with a healthcare provider to determine the best course of action, as noted in the guideline on pharmacological interventions for adults with obesity 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Additional Therapies for Weight Loss
In addition to taking Concerta (methylphenol hydrochloride) and Mounjaro (tirzepatide) for weight loss, several other therapies may be considered.
- Elimination diet and lifestyle modifications, as seen in a case report 2, where a 55-year-old post-menopausal obese female lost 18 pounds and 22.5 inches of girth over a six-week period.
- Behavioral treatment, as part of a comprehensive approach to manage weight, as suggested by obesity treatment guidelines 3.
- Motivational interviewing and self-determination theory, which were used in a functional nutrition approach to help a client lose weight 2.
- Surgical modalities, such as Roux-en-Y Bypass surgery, sleeve gastrectomy, and intragastric balloons, although these are associated with numerous side effects and require careful monitoring 4.
Tirzepatide Therapy
Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has been shown to be effective in managing blood sugar levels and enhancing weight loss 3, 4, 5.
- A phase 3 double-blind, randomized, controlled trial found that tirzepatide provided substantial and sustained reductions in body weight, with a mean percentage change in weight at week 72 of -15.0% to -20.9% 5.
- A health economics and outcomes research analysis found that compounded tirzepatide therapy produced a 5% reduction in body weight over four weeks, although the weight loss was not sustained after cessation of therapy 6.
Lifestyle Modifications
Lifestyle modifications, such as a nutrient-dense vegan diet, daily exercise, and weight-bearing exercise, may also be beneficial for weight loss and overall health 6.
- The investigator in the health economics and outcomes research analysis maintained weight-lifting strength and lap swimming speed, and increased endurance, while on compounded tirzepatide therapy 6.