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Living Well : Physical Activity

Exercise Options: Resistance Training

Resistance training can be a safe choice for many types of people. Learn the basics and, when you're ready to take things up a notch, add some variety to your program

Overview of resistance training

One way to help keep weight off is resistance training, also called strength training or weight lifting. This sort of training can be safe even if your health is poor.

Resistance training can boost your metabolism, which helps burn calories and control weight. It can also help alleviate health problems such as diabetes, heart disease, and back pain. Further, resistance training improves muscle strength and endurance, which can benefit you with all your physical activities.
You could try doing resistance training on 2 days per week, but not on consecutive days. You could achieve best results by performing 8 to 10 exercises repeated 8 to 12 times, until you feel fatigue.

The basics

These can be good ways to start a resistance training program that do not require any special equipment. Once you’ve been doing resistance training for a while, you may be able to use some of these techniques, even if you’re feeling a little off. This can let you stay in shape even if you need to take a break. If your healthcare provider approves, here are a few things you could try:

Remember to breathe regularly throughout all of these activities.

A 5-minute walk

5 minute walk

We’ve talked about walking in other chapters. A short walk can be a very good warm-up for resistance training.

Squats

squats

Stand in front of a chair with your arms straight out in front of you, keeping your weight on your heels. Slowly bend your knees while counting to 4, then on the count of 4, you should be sitting in the chair. Pause, then count to 2 as you stand back up. Do this 10 times. Rest for a minute, then do another set of 10. For your safety, never let your knees move past your toes; this could strain your knees.

Wall push-ups

Wall Push-Ups

Stand a little more than an arm’s length from a wall. Lean forward and rest your hands against the wall, then lean into the wall by bending your elbows as you count to 4. Keep your hands flat against the wall and your feet flat on the floor. Count to 4 again as you push back until your arms are straight. Repeat 10 times. Rest a minute, then do 10 more.

Toe stands

Toe Stands

Stand with your feet about shoulder-width apart. Use a counter or chair for balance as you slowly rise up to the balls of your feet. Stay up for 2 to 4 seconds, then slowly lower your heels back to the floor. Remember to breathe regularly throughout and use the counter or chair for balance only. As you become more advanced at toe stands, you may be able to do them with the balls of your feet on the edge of a stair.

Finger marching

Finger Marching

Do each of the movements listed below. Cycle through all 3 of them, 3 times in total.

  • Sit or stand with your feet on the floor and imagine a wall in front of you. Rest your hands on this imaginary wall. Slowly walk your fingers up the wall until your arms are above your head. Wiggle your fingers with your hands up for about 10 seconds, then walk them slowly back down
  • Try to touch your hands behind your back. Grab your elbow if you can. Hold this position for 10 seconds. Feel the stretch in your back, arms, and chest. Release
  • Interlace your fingers in front of you. Raise your arms until they are level with the ground. Twist your wrists so that your hands face away from you and hold for 10 seconds. This step on its own also makes a good stretch when cooling down

Stepping it up

Once you’ve done this program for a couple of weeks, you may be ready to step it up. Consult with your healthcare provider.

Some of these techniques require weights, others do not; all can be done at home. You could start with 2- to 3-lb weights and work your way up slowly; this will minimize your risk of injury. Your goal could be to perform up to 10 repetitions. If your healthcare provider approves of these exercises, remember to practice all of these techniques with a slow, controlled motion.

Without weights:

Step-ups

Step-Ups

Stand next to a handrail at the bottom of a staircase. Keep your feet flat and your toes facing forward. Put your left foot flat on the first step. While holding the handrail for balance, put your weight on your left leg and slowly use that leg to lift you until your right foot can tap the edge of the stair. Do not let your left knee move forward past your ankle. Pause, then slowly lower your right foot back to the floor. Repeat 10 times with the left leg and 10 times with the right. Rest for a minute, then repeat the set of 20.

Side hip raise

Side Hip Raise

Rest your hands on the back of a sturdy chair, with your feet slightly apart and your toes facing forward. Slowly lift your leg out to the side as you count to 2. Keep both legs straight, but do not lock your knees. Pause, then slowly lower your left foot back to the ground as you count to 4. Do 2 sets of 10 on each leg in a slow, controlled motion. As you become more practiced, you may choose to add ankle weights.

With weights:

Biceps curl

Biceps Curl

Stand or sit with a dumbbell in each hand, your feet shoulder-width apart, and your arms at your sides. The palms of your hands should be facing your thighs. Rotate your forearms outward as you slowly lift the weights while counting to 2. When you finish, you should have your hands in front of your shoulders with your palms facing you and your elbows still at your sides. Pause, then slowly lower the dumbbells to their original position while counting to 4. Do a set of 10, then rest one minute. After a minute, complete a second set of 10.

Overhead press

Overhead Press

With your feet about shoulder-width apart, hold a dumbbell in each hand at shoulder height, your palms facing forward. Slowly raise the dumbbells over your head while counting to 2 until your arms are fully extended overhead. Keep your neck and shoulders relaxed and remember to breathe regularly. Do not lock your elbows. Pause, then slowly lower the dumbbells as you count to 4. Repeat 10 times. Rest a minute, then repeat 10 more.

Adding variety

These activities can help you add variety to your routine if you are becoming more advanced. If your healthcare provider says you’re ready, you may want to try some of the following:

These techniques require ankle weights and should be done together.

Knee extension

Knee Extension

Sit back in a chair with ankle weights on snugly, your feet just touching the floor. (Put a rolled-up towel under your knees if your chair is too low.) With toes pointed forward, flex your left foot, and slowly lift your leg as you count to 2. Extend until your knee is straight, then pause. Slowly lower your foot back to the floor as you count to 4. Repeat 10 times with each leg. Rest for one or 2 minutes, then do a second set of 10.

Knee curl

Knee Curl

Stand behind a chair with your ankle weights on and your feet just a little less than shoulder-width apart. Slowly bend your right leg as you count to 2. Keep your knee down and your foot flexed. Pause, then slowly lower your foot back to the floor as you count to 4. Repeat 10 times with each leg. Rest for one or 2 minutes, then do a second set of 10.

These techniques strengthen the abdomen and back and should be done together:

Pelvic tilt

Pelvic Tilt

Lie flat on your back. Keep your knees bent, your feet flat, and your arms at your sides with the palms of your hands flat on the floor. Slowly roll your pelvis toward your abdomen, raising your hips and lower back off the floor as you count to 2. Make sure your shoulders stay flat on the floor. Pause, then lower your pelvis back to the floor as you count to 4. Repeat 10 times, rest for one or 2 minutes, then do a second set of 10.

Floor back extension

Floor Back Extension

Lie face-down on the floor with your left arm extended forward in line with your body and your right arm at your side. Slowly lift your left arm and right leg off the ground as you count to 2. Your head, neck, and back should be in a straight line. Pause, then slowly lower your arm and leg to the floor as you count to 4. Repeat 10 times with the left arm and right leg, then 10 more with the right arm and left leg. Rest for one or 2 minutes, then do another set of 10 on each side.

Warming up and cooling down

It is important to warm up before exercise and cool down after. This can help you stretch your muscles and may also help avoid strains, pulls, and cramps. Warming up also helps your heart and circulatory system make the transition from rest to exercise and back to rest. You could try warming up for at least 5 minutes before a 30-minute exercise session, and follow with at least 5 minutes of cooling down.

In general, a good warm-up is the same activity at a lower intensity. For example, walking slowly is a good warm-up for brisk walking; brisk walking can be a warm-up for running. Choose a warm-up that you can do comfortably. Check with your healthcare provider if you have specific needs or problems.

When you begin any activity, start slowly. Increase your pace gradually. To end your session, decrease the pace slowly. You could finish with some combination of the techniques described below: they are worth the time and can prevent injuries that might limit your activity for a long time.

Chest and arm stretch

Chest and Arm Stretch

Stand with your arms at your sides and your feet about shoulder-width apart. Extend your arms behind your back and clasp your hands together. Keep your back straight, relax your shoulders, and look straight ahead. Hold this stretch for a slow count of 20 to 30 seconds. Remember to breathe throughout. Release the stretch and repeat.

Hamstring/calf stretch

Hamstring/Calf Stretch

While standing in front of a chair, slowly bend forward at the hip, keeping your back and legs straight without locking your knees. Put your hands on the chair seat, keeping your elbows slightly bent. You should feel a stretch in the back of your upper and lower leg. Hold this stretch for a slow count of 20 to 30 seconds. Remember to breathe throughout. Release the stretch and repeat. If you don’t feel a comfortable pull on the backs of your legs, try bending your elbows more.

Quadriceps stretch

Quadriceps Stretch

Hold a chair or a counter for balance with your left hand. Keep your feet about shoulder-width apart and your knees straight but not locked. Bend your right leg back and grab your foot or ankle with your right hand. Pull your foot or ankle until your knee is pointing straight down. Do not lean forward; look straight ahead. Hold this stretch for a slow count of 20 to 30 seconds. Remember to breathe throughout. Release the stretch and repeat with your left leg.

Neck, upper back, and shoulder stretch

Neck, Upper Back, and Shoulder Stretch

The third step from the "finger walking" warm-up stretch also works as a cool-down stretch, though the cool-down should be held longer. Interlace your fingers in front of you. Raise your arms until they are level with the ground. Twist your wrists so that your hands face away from you. Remember to hold for a slow count of 20 seconds without curving or arching your back.

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INDICATION

Qsymia® should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

Limitations of Use:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

It is not known if Qsymia is safe and effective in children under 18 years old

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Qsymia can cause serious side effects, including:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Women who are pregnant must not take Qsymia. Women who can become pregnant should have a negative pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Possible side effects of Qsymia include:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Common side effects of Qsymia include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS, Inc. at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide and Full Prescribing Information.

The Q and Me Patient Resources and Education site is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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