I feel so bad for people Topomax reasons and are told a side effect can be weight loss but are disappointed when they don't lose weight. The problem, according to my psychiatrist, is that doctors are for some reason not prescribing the other part of the FDA approved med combination for weight loss: Ritalin. With the right titration of Topomax and Ritalin (I need both for treatment of bipolar disorder), I have lost 90 lbs (6.4 stone) in five months. My brain responds beautifully to the med combination, and my appetite has virtually disappeared. I do not eat due to hunger. I eat due to a sense of weakness. Walking five miles a day and using the Myfitnesspal app available on both iPhone and Android has done the trick for me. But the key is not to rely on Topomax alone. It must be taken in combination with Ritalin.