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The transcription factor ATF4 in turn activates stress-responsive genes such as Tribbles homolog 3 (Trib3) and solute carrier family 7 member 11 (Slc7A11) to mediate protective effects of the integrative stress response 16

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Studies have shown that topiramate can be nearly as effective for weight loss as phentermine combined with topiramate over a 1-year period 5.1.5 Effectiveness After GLP1 Therapy While no large-scale clinical trials specifically examine topiramate for post-GLP-1 maintenance , indirect evidence is compelling: Studies have shown topiramate produces 510% weight loss as monotherapy, with less weight regain over time