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Complementary approaches may include: Behavioral therapy or weight management counseling Sleep optimization (79 hours nightly) Stress management techniques Evaluation and treatment of coexisting conditions (insulin resistance, sleep apnea, depression) FDA-approved oral weight loss medications (orlistat, phentermine/topiramate ER, naltrexone/bupropion) as alternatives to injectables (note: phentermine monotherapy is approved for short-term use only) Patients should maintain realistic expectationsweight loss may be slower with hypothyroidism, even when well-controlled

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Kim ES, Jeon MT, Kim KS, Lee S, Kim S, Kim DG

Arch Dermatol Res 289:256260 Darsow U, Ring J (2001) Neuroimmune interactions in the skin

Curr Opin Pulm Med 5(3):128 Fachini-Queiroz FC, Kummer R, Estevo-Silva CF, Carvalho MDB, Cunha JM, Grespan R, Cuman RKN (2012) Effects of thymol and carvacrol, constituents of Thymus vulgaris L