Weight loss medicine is about appetite suppressants (phentermine, phendimetrazine, diethlypropion, benzephetamine) and medications that curb sweet and starch cravings (Topemax, Zonegran, Naltrexone, Aplenzin, DPP4 inhibitors plus metformin, Victoza, Symlin, Byetta, Bydurion, Vitamin D). 25% of the time, the magic that I do is that I stop a prescription medication that is causing fat storage. 5% of the time, I find a medical problem that needs treatment. 50% of the time, patients take prescription medications that help curb carbohydrate cravings. Topemax and Zonegran are childhood epilepsy medications, that were found to be effective for migraine headaches. Topemax was eventually approved for migraines. Both can help weight loss by limiting hunger and carbohydrate cravings. Naltrexone is a medication that curbs alcohol and narcotic cravings, and also helps weight loss by limiting carbohydrate cravings. Aplenzin is a once a day, time release form of the antidepressant Wellbutrin, that can help weight loss by curbing hunger and carb cravings. DPP4 inhibitors in combination with metformin improve compliance by limiting hunger and sweet and starch abuse. GLP1 agonists (medications that increase the amount of GLP1 in the body) Victoza, Symlin, Byetta and Bydurion, help weight loss by limiting fat storage and decreasing appetite. GLP1 is one of the 4 hormones that control body weight. The other 3 hormones are insulin, leptin and ghrelin. The higher your insulin and ghrelin levels, the more you store fat, and the hungrier you are. The higher your GLP1 and leptin levels, the less you store fat and the less hunger you experience. Vitamin D can also help decrease hunger and carbohydrate cravings. Qnexa is a combination of phentermine and Topemax. Contrave and Empatic are combinations of Wellbutrin and Zonegran. In general, diet doctor’s don’t like combination medications, because we like specific dosage for specific patients. One size does not fit all.