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Phentermine (and the combination drug phentermine-topiramate/Qsymia) can trigger telogen effluvium through rapid weight loss and has been associated with changes in nutrient balance

doi: 10.1016/j.smrv.2018.06.001 89 CarsonSAKallenAN

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It is not approved for human or veterinary use, and is not intended for diagnostic, therapeutic, or clinical applications

doi: 10.1016/j.peptides.2018.07.008

When to investigate poor response Losing less than 5% body weight by week 12 despite consistent dosing and reasonable dietary adherence signals need for evaluation