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introducing any changes to your diet or level of physical activity.

Living Well : Support and Motivation

Your Ongoing Journey

If you've lost weight, you've reached a crucial point. Keeping it for the next few years boosts your odds of keeping it off long-term

How far you’ve come

Giving yourself credit for all the work you’ve done so far can also give you some of the strength to stick with it for life–and you will need that strength to stay on the path. It will still be work. Even now you may have times when you struggle. There may still be times when you wonder if it’s really worth the work to keep the weight off. But now you have the tools that can help you make it work.

Q and Me addresses a wide variety of topics, including healthy eating habits, staying active, eating a healthy breakfast, and how to track your progress. Now it’s time to look to the future. We hope that the habits you’ve learned have served you well so far and will help you succeed in the journey yet to come.

The road ahead

As you continue your journey, keep using your tracking tools. Tracking your progress can be vital to help you keep off the weight you’ve lost and lose more weight, if that is what your healthcare provider recommends.

Even more important, keep making good choices. Now is a crucial time in your journey. If you keep the weight off for the first few years, you will boost your odds of keeping it off long-term. In fact, if you reach the 2-year milestone, your risk of gaining back the weight drops by almost half. Make it 5 years and your risk of putting weight back on will be reduced by nearly 70%.

The longer you succeed, the longer into the future you are likely to keep the weight off. Be consistent in your habits. All the lessons you’ve learned so far can only work if you keep making them a part of your day-to-day life. The better you stick to your routine, the longer the weight is likely to stay off. If you stay consistent long-term, you may make your weight loss a lifelong success.

So what does it mean to be consistent?

Consistent eating habits

Try to keep your eating habits steady. This doesn’t mean you could never eat anything sweet again—in fact, one study found that, with careful eating habits, people lost weight even if they ate chocolate once a day. But it does mean you need to watch out for minor lapses that can turn into major setbacks. In particular, try the following:

  • Consistently track what you eat. Remember, the better you keep track of the foods you eat, the more likely you are to lose weight and keep it off.
  • Don’t take days off. Stay on track even when you're on holiday. Taking weekends or holidays off can make it harder to keep weight off. One study asked long-term weight losers to rate how much their eating habits varied on weekends and holidays. The results showed that those who were consistent in their habits lost more weight and kept it off longer.
  • Cook your own food. Many successful weight losers take most of their meals at home. Cooking for yourself can help you make smart meal choices and stay away from fast food.

By now you may have found some recipes that fit with your healthcare provider’s approved meal plan and that are fun to make. Finding healthy foods you may like to cook at home is something you might enjoy daily.

Consistent physical activity

Try to maintain your activity level every week, even during busy times. It takes work, but you can make plans to keep active during holidays or even when you’re swamped at work.

We’ve talked about some strategies you could follow to stay active. You may want to look back at these strategies now. Maybe you could find one you can use but haven’t tried yet. Remember: One of the most important things about physical activity is sticking with it.

As mentioned, one more good way to keep active is just to keep good records. If you consistently keep track of your physical activity, it’ll probably be easier for you to stay active, and you may lose more weight.

If you slip, get right back up

This may be the key lesson for the long road ahead. As much as we talk about being consistent, it’s good to remember that no one’s perfect. And as much as you’d like to stay on track all the time, there will probably be times when you slip. As we’ve mentioned before, how you handle a minor slip can make a big difference.

Sometimes when people have a lapse, they may think they’ve failed; others may try to “get it out of their system” before they get back on track. The farther you go off track, the harder it will be to get back on—but if you pick yourself up right away, it might not be hard at all. A stumble isn't the end of the world and shouldn’t mean the end of your healthy habits.

A stumble is not a failure. Talk to your healthcare provider, learn from your mistake, and get right back to your routine.

Actions

  • Think about the positive changes you’ve probably made in your eating habits, physical activity, and weight.
  • Together with your healthcare provider, set a long-term weight goal. This should be a weight range you and your healthcare provider find acceptable for you to keep for a long time—perhaps the rest of your life. For starters, it can be a weight goal for the following 12 months, such as maintaining your current weight or losing more weight. If you want to lose more weight, please remember that it may be more difficult than when you first started. See what your healthcare provider recommends.
  • Talk with your healthcare provider about whether you should keep taking Qsymia®. Depending on your new weight goal, your healthcare provider may prescribe a different dose. Whether you keep taking Qsymia or not, Q and Me is always there to support you.
  • As always, record your weight, eating habits, and physical activity in your tracking tool of choice.
  • You may want to look over your tracker entries to find the times when you’ve slipped up and think about strategies to stay on track the next time. Talk with your healthcare provider about developing solid strategies you can use in the future.
  • Together with your healthcare provider, develop a long-term plan to keep you in shape for the long haul.

Good luck!

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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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