<![CDATA[Obesity is a chronic medical condition requiring long-term management because lifestyle modification alone often does not provide optimal outcomes. Topiramate is an antiepileptic drug also used for weight management as part of combination or adjunctive therapy. This study aimed to evaluate the effectiveness and safety of topiramate in obesity management. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the Population, Intervention, Comparison, Outcome (PICO) framework. A literature search was conducted in PubMed, Scopus, and Google Scholar for English-language full-text articles published between 2021 and 2026. Data were qualitatively analyzed using narrative synthesis, with changes in body weight as the effectiveness outcome and the type and frequency of adverse events as safety outcomes. Of 939 identified articles, eight met the inclusion criteria and were eligible based on the Joanna Briggs Institute (JBI) quality assessment, with scores ranging from 61.5% to 92.3%. Topiramate-containing regimens generally supported weight loss in individuals with overweight or obesity and were generally tolerable. Common adverse events included paresthesia, dizziness, headache, and memory or concentration disturbances. However, the individual contribution of topiramate could not be determined because all included studies involved combination therapy and/or accompanying interventions.]]>
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