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You should always consult with your healthcare provider before
introducing any changes to your diet or level of physical activity.

Living Well : Physical Activity

Exercise Options: Vigorous Exercise

If your healthcare provider approves, try more challenging activities that can burn calories faster

A more vigorous routine can burn calories faster

Most overweight people can become more active just by walking. By now, you may feel more comfortable being active and your healthcare provider may want you to try a more vigorous form of physical activity. Examples would be running instead of walking and can be standing instead of sitting. More vigorous activity can help you burn more calories and may also improve your overall fitness.

If you’ve been walking regularly, that’s fantastic! It can be OK to stick with walking alone! A regular walking program can benefit you tremendously. The best activity is the one you do. If you are happy with walking and that’s all that your plan prescribes, then keep walking, and keep up the good work!

However, if your healthcare provider recommends you try something more vigorous, you may wish to try running, cycling, aerobics, swimming, or any other regular activity. Consult with your healthcare provider and choose something you like and will want to do again. Many people use more than one type of activity to lose weight. This can keep it from getting too dull and can let you change your routine with your mood. It also can allow you to be flexible with your schedule and the weather. For example, you might walk some days, bicycle other days, and do an aerobics class when one is scheduled.

Three of the most popular activities are running, cycling, and aerobics. Keep reading to find out if one of these activities may be right for you and how you might get started.

Running

There are many benefits to running. It can bring on many physical changes as well as advantages to the psyche, which can sometimes be overlooked. Running can give you a sense of accomplishment, self-confidence, well-being, and good feelings. Running has a lot going for it!

Many people enjoy running, but if you still have many pounds to lose, brisk walking can be easier, and it gives almost the same health advantages. Running can help some people, but walking can be a fine alternative.

If running can be part of your physical activity program, and you decide to give it a try, it’s important to start gradually. You could start by adding short periods of running to your walks. Each week, run a little more and walk a little less. It’s important to build your runs slowly—you may be ready to run the whole time in several months. As with any activity, consult with your healthcare provider and be sure to warm up and cool down.

When you run, your head should be up. Look straight ahead. Keep your shoulders relaxed, and swing your arms forward and back. Push off with the ball of your foot and land on your heel to midfoot.

Make sure to rest between your runs! When you’re starting, don’t run more than every other day. If you want to run longer, and your healthcare provider recommends it, build slowly.

Many books are specifically designed to help you get started running. You may want to read more about running if you’re interested. If you have any questions about whether or how much running is right for you, talk to your healthcare provider.

Cycling

Cycling has the same advantages as running, and some people enjoy it more. Riding a bicycle or a stationary bike can be good exercise, and, unlike running, it doesn’t put the strain on your knees, ankles, and feet. It can also be nice for heavy people because the bike supports your weight. It can be a great way to burn calories. If you find the seat uncomfortable, there are now special gel seats to help.

If you can cycle outdoors, you may want to give it a try. Biking to work can be terrific if you can do it. If not, you could consider a stationary bike for your home. Stationary biking can be nice in bad weather. What’s more, you can watch TV or listen to music while you do it.

If you are cycling on the road, be sure to follow these safety tips:

  • Look and listen! Be alert for sounds like tires squealing or cars playing loud music, which could mean a driver is not in control or paying attention. When in doubt, pull over and let the car pass
  • Choose a smart route. It can be easier and more enjoyable to bike on roads that have few cars or a lower speed limit. Many cities and towns have special bike lanes on some roads as well
  • Indicate your turns with hand signals. Just like when you’re driving, you want to make sure cars and other bicyclists know where you’re going
  • Master the art of looking behind without swerving. Practice somewhere safe!

If you haven’t cycled in a while or are not a confident cycler, you can try starting in a local park or other no-car areas.

Aerobics

Aerobic activities make your body use a lot more oxygen. They tend to use large muscle groups and rhythmic movement. Walking, running, cycling, swimming, and jumping rope are aerobic activities, as are dancing to fast music and the other movements taught in aerobics classes. Aerobic activities improve cardiovascular conditioning. They are not the only exercises that can help you lose weight, but they are among the best.

Almost anyone can do aerobics, because it can be done in many ways. If you want to do it on your own, there are books, TV shows, and DVDs. Many aerobic routines can be found for free on YouTube! If you like company, aerobics classes are held in many gyms, churches, and community centers. Classes may include non-impact aerobics, step aerobics, kickboxing, and stationary biking. Water aerobics give you the benefits of aerobics with less strain on your joints. You also may want to try a jazzercise, ballroom dance, hip-hop, or Zumba® class. Ask your healthcare provider for recommendations.

A nice thing about aerobics is that you can move at your own pace, even if you are with a group. Don’t worry about the shape you’re in.

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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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