"started contrave with scale down program 4 weeks ago - just reached the level of 4 pills per day (2 am/2 pm).  have lost 7 lbs since start date (210 to 203).  only noticeable side effects are some fatigue, which got better after the first week, delayed period (about 5 days late), and hot flashes (for real, full body sweat).  subtle effect but i find that i feel full sooner and so i am not eating as often.  takes some getting used not to eat just because it is &quot;meal time&quot;."