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Could i take Qsymia for losing my weight and what is the cause for loud snoring at times?

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General & Family Physician
Practicing since : 2012
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I have been struggling with weight loss for many years and am planning a new attempt with a local weight loss clinic. I have heard of a new product called Qsymia, which apparently can only be used in conjunction with doctor's supervision and other weight loss techniques. I assume the fact that I snore is related to this issue. However, my wife tells me that my snoring varies - sometimes I don't snore at all, or little, and other times I snore very loudly. She also says that at times she hears me "moaning and groaning." However, she does not - nor do I - believe that I have any issues related to breathing (apnea), and that I breathe normally. I would appreciate your input on these matters. Of course I realize that if I lost 35 kilos I wouldn't snore anymore at all.
Posted Tue, 14 Jan 2014 in General Health
Answered by Dr. Shafi Ullah Khan 59 minutes later
Brief Answer: Weight loss,Airway evaluation Detailed Answer: Good Day Mr XXXX My name is Dr S Khan and i would like to help you with your issues of obesity and inclination towards Qsymia and snoring issues. Mr XXXXXXX i would want you to know that yes Qsymia is a drug Indicated for obesity as an adjunct to a reduced-calorie diet and exercise for chronic weight management with BMIs above 30( You can calculate your BMI here WWW.WWWW.WW ). Usually Qsymia is used only when there is at least 1 weight related comorbidity (eg, hypertension, type 2 diabetes mellitus, dyslipidemia).It is started at low doses and gradually increased over weeks and if after 12 weeks weight loss is less than 5 % BMI then it is gradually tapered to avoid side effects. And for all that it needs supervision as you alreay mentioned. But there are other less worried natural ways to lose weight. Low calorie diet more fibres and alot of exercise will get you reduce the weight enormously. Stay natural in this regard and dont lose weight in a hush it is not good at all. Let it be slow and natural and you will have nothing to worry about.Seek a dietitian help for guiding you with a dietary plan for weight loss. Now snoring . Mr XXXXXXX Obesity itself is the reason amongst many for this snoring. As you already mentioned headaches an sinuses , so i recommend an otorhinolaryngology clinic visit to evaluate airways and sort out etiology if any. Other wise losing weight and sleeping in trendelenburg position ( sidewise) will help reduce the snoring. sleeping flat/ straight block the airways further and obesity also plays role so that leads to snoring, Usually i advise tennis ball sewed to the back of the shirt as this creates discomfort while sleeping flat and patient turn to side during sleep and thus snoring is avoided. Plus you can also use appliances available over the counter for these snoring aids. So in Nut shell, the target for you is to reduce weight by natural means avoiding cheap publicity stunts and staying in touch with your healthcare provider and mean while let an otorhinolaryngologist assess the airways and find a solution for the snoring. Rest keep the medications you are having and enjoy every single moment of your life. Have a good rest of the day and every day after wards. If You have any more queries please feel free to ask otherwise i request you to kindly close the discussion and rate the answer as per your experience. Take some very good care of yourself and may the odds be ever in your favour. Regards Dr S Khan
Above answer was peer-reviewed by
Follow-up: Could i take Qsymia for losing my weight and what is the cause for loud snoring at times? 10 minutes later
Thank you kindly for your reply. Indeed, your email counterweights the overwhelming anxiety imposed on me by my family about weight loss, especially since my brother is using Qsymia on a weight loss program that he recently started. I saw that a contraindication relates to glaucoma, and my eye pressure is borderline for many years at 21 and 22 according to the US measurement system. I have consulted with 2 dieticians, and their recommendations are great in theory, but hard to keep in practice, especially since unlike my own brother I do not have the sugar craving, but perhaps for 20 years have not done sufficent walking (which is why I bought a stationary bicycle). It is more difficult (aside from family pressure) because on both sides of my family obesity has already been an issue. Could you tell me how important is the genetic factor in terms of things like metabolism etc.? My last blood tests showed normal thyroid and other things, helped along by supplements (D3, C, Niacin, Omega 3, etc.). With regard to snoring, my wife tells me that I do snore on my side and not just on my back. And I have tried appliances except for the one that extends the tongue away from the throat.
Answered by Dr. Shafi Ullah Khan 18 minutes later
Brief Answer: Bariatric surgery and airway evaluation Detailed Answer: Hello again Mr XXXX! Thank you for asking. As you have borderline galaucoma pressures and the CNS stimulants and anorexiants may worsen that so you need further monotoring while using it. Here is the list of adverse effects These Qsymia can have >10% Paresthesia (4.2-19.9%) Dry mouth (6.7-19.1%) Constipation (7.9-16.1%) URI (12.2-15.8%) Metabolic acidosis (6.4-12.8%) Nasopharyngitis (9.4-12.5%) Headache (7-10.6%) 1-10% Insomnia (5-9.4%) Dysgeusia (1.3-9.4%) Dizziness (2.9-8.6%) Increased serum creatinine (2.1-8.4%) Sinusitis (6.8-7.8%) Nausea (3.6-7.2%) Bronchitis (4.4-6.7%) Back pain (5.4-6.6%) Diarrhea (5-6.4%) Blurred vision (4-6.3%) Fatigue (4.4-5.9%) UTI (3.3-5.2%) Hypokalemia (persistent) (0.4-4.9%) Cough (3.3-4.8%) Depression (2.8-4.3%) Anxiety (1.8-4.1%) Irritability (1.7-3.7%) Alopecia (1.7-3.7%) Hypoesthesia (0.8-3.7%) Disturbance in attention (0.4-3.5%) GERD (0.8-3.2%) Extremity pain (2.1-3%) Musculoskeletal pain (0.8-3%) Muscle spasms (2.8-2.9%) Dyspepsia (2.1-2.8%) Sinus congestion (2-2.6%) Rash (1.7-2.6%) Pharyngeal pain (1.2-2.5%) Dry eye (0.8-2.5%) Gastroenteritis (0.8-2.5%) Hypokalemia/ Low potassium (acute) (0.4-2.5%) Palpitations (0.8-2.4%) Eye pain (2.1-2.2%) Neck pain (1.2-2.2%) Oral paresthesia (0.2-2.2%) Decreased appetite (1.5-2.1%) Nephrolithiasis (0.2-1.2%) Dysmenorrhea (0.4-2.1%) Chest discomfort (0.2-2.1%) Thirst (1.8-2%) Nasal congestion (1.2-2%) Postmarketing Reports Phentermine Allergic: Urticaria Cardiovascular: Increased blood pressure, ischemic events CNS: Euphoria, psychosis, tremor Reproductive: Changes in libido, impotence Topiramate Dermatologic: Bullous skin reactions (eg, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), pemphigus Gastrointestinal: Pancreatitis Hepatic: Hepatic failure (including fatalities), hepatitis Metabolic: Hyperammonemia, hypothermia Ophthalmic: Maculopathy Now the Obesity issue. Mr XXXXXXX as you mentioned you last 20 sedentary years of lifestyle has made it difficult further to lose weight. You need to reduce your energey expenditures. and use conventional diets like Low-fat diets - Eg, the Ornish diet Low-carbohydrate diets - Eg, the XXXXXXX diet Midlevel diets - Eg, the Zone diet, in which the 3 major macronutrients (fat, carbohydrate, protein) are eaten in similar proportions of 30-40%) Joslin Why WAIT diet for diabetic patients - 40-45% carbohydrates, 20-30% protein, less than 35% fat Sign up to some weight-loss programs, such as those advocated by XXXXXXX XXXXXXX Weight Watchers, Take Off Pounds Sensibly (TOPS), and Overeaters Anonymous (OA). You can try Reduced ΜΆ portion size diets.portion control can be achieved by participation in structured weight loss programs (eg, XXXXXXX XXXXXXX Nutrisystem) or by the purchase of products such as meal-replacement shakes, bars, prepackaged meals, and frozen entrees (eg, Slim-Fast, Glucerna, Lean Cuisine, Healthy Choice, Smart Ones) Also Alcohol, sodas, most fruit juices, and highly concentrated sweets are generally calorie dense and nutrient deficient (so-called empty calories). Consequently, these are generally prohibited or reduced to a minimum. Drink cold water 10 ml per kg before every meal. As study has shown that people who consumed 500 mL of water prior to each daily meal had a 44% greater decline in weight over 12 weeks than did individuals on a hypocaloric diet without premeal water consumption. You need behavioural changes and exercises. As you mentioned disability then i think you should consider the Option of Bariatric surgery. They are the only solution of losing weight And proved effective but again age of 57 would be a little impediment for that. Any ways seek the Docotrs opinion for bariatric surgery. Now the snoring i mentioned once you lose weight it will be gone, and otorhinolaryngologist will evaluate airways to find if there is any thing else other than obesity as a factor for snoring. Lets focus on the weight loss first and snoring will resolve with it. Mr XXXXXXX Hope i was of some service. Kindly dont forget to close the discussion and rate the answer if you have no more queries for me. have a very good rest of the day. Yours sincerely Dr S Khan
Above answer was peer-reviewed by
Follow-up: Could i take Qsymia for losing my weight and what is the cause for loud snoring at times? 20 minutes later
Thank you. I am fearful about bariatric surgery. Especially since you indicate I may be too old for it. On the other hand, I don't think I want to engage in diet shopping. Would the Zone Diet be preferable?
Answered by Dr. Shafi Ullah Khan 54 minutes later
Brief Answer: All options provided, Let them decide whats best Detailed Answer: Don't worry Mr XXXXXXX I just mentioned age as a factor for anaesthesia. bariatric surgery is safe and have good result. Seek the second opinion in this regard and let them choose what is best for you. And regarding all diets and programmes i mentioned, the more you opt the better it is. Seek the dietitian and let him help you with a plan, If you need to lose weight. You need to do something about it. Now the zone diet AKA medievel diets is preferable but not enough for your case. I put all the options in front of you possible for you to lose weight. Let your healthcare providers decide what is best for you. Discus the odds and pro and cons of these manoeuvres and see what comes best for you. best wishes from my side. Lets hope evrey thing comes up normal. May you get what you are looking for. Happy holidays. Don't forget to close the discussion. Good Luck Regards Dr. S Khan
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