Citations 2
Addition of Phentermine‐Topiramate to a Digitally Enhanced Lifestyle Intervention: A Double‐Blind Randomized Clinical Trial
Campos, Alejandro , Ghusn, Wissam , Cifuentes, Lizeth , Sacoto, Daniel Hernan, Fansa, Sima , Añazco, Diego , Ricardo‐Silgado, Maria L., Harmsen, W.L., Gunn, Heather J., Peterson, Craig, Larsen, Deborah, Varghese, Santosh T. , Hurtado, M D, Acosta, Andres, Campos, Alejandro , Ghusn, Wissam , Sacoto, Daniel , Hashem, Anas , Schaefer, Megan, Gunn, Heather , Hurtado, Maria Daniela , Acosta, Andres , Anazco, Diego , Ricardo-Silgado, Maria Laura , Schaefer, Megan, Gunn, Heather
Obesity | January 21, 2026 | Volume: 34 | Issue: 3 | Pages: 524-536
ABSTRACT Objective This study compared the effects of phentermine‐topiramate‐ER (mid‐dose 7.5/46 mg) versus placebo on weight loss and cardiovascular disease (CVD) risk outcomes when used as an adjunct to a digitally enhanced lifestyle intervention (DELI). Methods We conducted a 12‐month, randomized, double‐blind, placebo‐controlled trial at a single tertiary academic center in the United States (June 2020–June 2022). Eighty participants with obesity (BMI ≥ 30 kg/m 2 ) were enrolled in the DELI program, consisting of in‐person and telehealth modalities, dietary and physical activity goals, and use of a smartphone application integrated with digital devices (Apple Watch and Bluetooth‐enabled weight scale and blood pressure monitor). Participants were randomized 1:1 to receive either phentermine‐topiramate‐ER ( n = 42) or placebo ( n = 38) in addition to the DELI. Results At 3 months, the phentermine‐topiramate group lost a mean of 10.82 kg versus 4.04 kg in the placebo group (mean difference −6.78 kg; p = 0.002). At 12 months, weight loss was 15.32 kg versus 5.85 kg, respectively (mean difference −9.48 kg; p < 0.001). Participants receiving phentermine‐topiramate‐ER experienced a 3.35% reduction in the estimated atherosclerotic CVD risk compared to baseline ( p = 0.004). Conclusions Phentermine‐topiramate‐ER, when combined with a DELI, produced significant and sustained weight loss and reduced CVD risk in adults with obesity. Trial Registration ClinicalTrials.gov : NCT04408586
Leveraging the Individualized Metabolic Surgery Score to Predict Weight Loss with Tirzepatide in Adults with Type 2 Diabetes and Obesity
Castaneda, Regina , Sepulveda, Diego, Gutierrez, Rene Rivera, Villamarin, Jose, Bechenati, Dima , Espinosa, Maria A., Verastegui, Alfredo , Tama, Elif , McNally, Allyson W, Bennett, Pamela K, Acosta, Andres, Andrade, Maria D. Hurtado, Acosta, Andrés , Hurtado, Maria D. , Villamarin, Jose L. , Sepulveda-Gonzalez, Diego , Bechenati, Dima , Hurtado, Maria Daniela , Acosta, Andres , Espinosa, Maria Antonia , Villamarin, Jose , Verastegui, Alfredo , Tama, Elif , McNally, Allyson W , Castaneda, Regina , Sepulveda, Diego , Gutiérrez, René de Jesús Rivera
Diabetology | January 5, 2026 | Volume: 7 | Issue: 1 | Pages: 10
Background/Objectives: Individuals with type 2 diabetes (T2D) achieve less total body weight loss (TBWL) with obesity medications compared to those without T2D. The individualized metabolic surgery (IMS) score, originally developed to predict T2D remission after bariatric surgery, inversely correlates with TBWL response to semaglutide. IMS reflects T2D severity, incorporating HbA1c and T2D duration and medication use. This study aims to evaluate TBWL with tirzepatide across IMS severity categories and identify predictors of response in a real-world cohort. Methods: This retrospective analysis included 717 adults with T2D using tirzepatide for overweight or obesity within the Mayo Clinic Health System. Patients were stratified by IMS severity (mild, moderate, severe) and quartiles. Primary endpoint: TBWL% at 15 months. Secondary endpoints: categorical thresholds (≥5%, ≥10%, ≥15%, ≥20%) and predictors of TBWL%. Linear mixed-effects models and regression models were employed. Results: At 15 months, TBWL was greater in mild versus severe IMS groups (14.8% vs. 11.0%, p = 0.015), with similar trends across quartiles. The proportion achieving ≥ 20% TBWL was nearly two-fold higher in mild versus severe IMS (27% vs. 14%, p = 0.03). Female sex independently predicted greater TBWL, whereas insulin use, higher T2D medication burden (particularly weight-promoting agents), and HbA1c > 7% were associated with less TBWL. Conclusions: Tirzepatide produced clinically meaningful TBWL across all IMS categories, although TBWL declined with increasing IMS severity. Glycemic control and T2D medication use emerged as strong predictors of TBWL. The IMS score may serve as a practical tool to anticipate weight-loss trajectories, guide personalized treatment decisions, and inform patient counseling.