
Although the FDA has not approved Topamax (topiramate) as a weight loss supplement, taking it for other conditions such as migraines may result in weight loss as a side effect.
Depending on the condition being treated, the starting dose of Topamax is typically 23 mg. Your doctor may increase your dose to 46 mg after the initial 15 days, provided you tolerate the drug well. The maximum dose of topiramate that may be consumed in a day is 92 mg.
While taking Topamax may cause you to lose weight, it’s important to remember that weight loss depends on many factors, such as genetics, lifestyle, overall health, and other medications.
What is Topamax?
Topamax is an anticonvulsant medication that is used to treat:
- Epilepsy and seizures
- Migraine
- Headache
- Anxiety
- Bipolar disorder
- Borderline personality disorder
- Nerve pain
Topamax dosages vary depend on the condition being treated:
How is Topamax related to weight loss?
Although studies have suggested that Topamax may result in weight loss, the exact reason for this is unknown. Possible reasons include the following:
- Suppresses appetite: Studies have shown people who take this medication may experience appetite suppression or reduction as a side effect.
- Controls addiction: Clinical trials have shown that topiramate targets addiction centers of the brain by changing neural pathways that work within these centers and reducing the overexcitation of nerves there. As a result, stress-induced bingeing behavior may be reduced.
- Alters hormone levels: Topiramate consumption reduces the amount of leptin, which is a hormone related to the stress hormone cortisol. Leptin regulates appetite, and when it is low, it can cause you to feel less hungry.
- Disorientation: Topamax can cause dizziness and disorientation as a side effect, which may lead to people refusing or forgetting to eat.
- Ketosis: Topamax causes fluctuations in blood glucose and insulin levels, which may induce ketosis. Ketosis is a state in which the body uses fat as fuel, resulting in significant weight loss.
- Boosts metabolism: Topamax may help speed up metabolism, which can contribute to weight loss.
- Reduces saliva production: Topamax reduces saliva production, which can affect taste. Loss of taste can in turn lower appetite and cause you to eat less.

SLIDESHOW
The Best Diet Tips: How to Lose Weight the Healthy Way See SlideshowWhat are the possible side effects of Topamax?
Topiramate has numerous serious side effects that some people may find too severe to continue taking for treatment. Side effects may include:
- Problems with speech or balance
- Chest pain
- Stomach pain
- Tiredness
- Dizziness
- Depression
- Agitation
- Seizures
- Fast or pounding heartbeat
- Fainting
- Blurred vision
- Lightheadedness
- Kidney stones
Topiramate toxicity symptoms are similar to those of an overdose. However, in severe cases, status epilepticus has been observed. Status epilepticus is a seizure lasting more than 5 minutes or 2 or more seizures occurring within 5 minutes of each other without the person returning to normal in between the seizures. This is a potentially fatal situation.
Is it safe to take Topamax for weight loss?
Although some doctors may prescribe Topamax off-label to help someone lose weight, it’s important to keep in mind that the drug can cause serious side effects. Taking it is not a substitute for creating a balanced weight loss plan. Talk to your doctor to see if it is right for you.
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https://www.mayoclinic.org/drugs-supplements/phentermine-and-topiramate-oral-route/proper-use/drg-20075700
https://www.uptodate.com/contents/topiramate-drug-information?search=topiramate&source=panel_search_result&selectedTitle=1~148&usage_type=panel&kp_tab=drug_general&display_rank=1
Topiramate in Bipolar and Schizoaffective Disorders: Weight Loss and Efficacy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181115/
Eating disorders may be treated by Topamax: https://www.consumerreports.org/cro/2012/04/eating-disorders-may-be-treated-by-topamax/index.htm
Predictors of Weight Loss in Adults with Topiramate-Treated Epilepsy: https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2003.78
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