Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.
‡The results presented here are from the combined studies supporting FDA approval of Qsymia. Qsymia was studied in 2 large trials that involved 3754 patients whose BMI was 27 kg/m2 or greater. The average baseline weight of the subjects in the 2 studies was 256 lbs and 227 lbs. Patients were randomized to placebo, phentermine 3.75 mg/topiramate 23 mg, phentermine 7.5 mg/topiramate 46 mg, or phentermine 15 mg/topiramate 92 mg.
Sleep is an essential component to maintaining health. In children, sleep is also vital for growth and development. Ongoing sleep deprivation has been linked to an increased risk for some chronic health problems. In addition, sleep deprivation has been shown to correlate with both increased susceptibility to illness and slower recovery times from illness.[47] In one study, people with chronic insufficient sleep, set as six hours of sleep a night or less, were found to be four times more likely to catch a cold compared to those who reported sleeping for seven hours or more a night.[48] Due to the role of sleep in regulating metabolism, insufficient sleep may also play a role in weight gain or, conversely, in impeding weight loss.[49] Additionally, in 2007, the International Agency for Research on Cancer, which is the cancer research agency for the World Health Organization, declared that "shiftwork that involves circadian disruption is probably carcinogenic to humans," speaking to the dangers of long-term nighttime work due to its intrusion on sleep.[50] In 2015, the National Sleep Foundation released updated recommendations for sleep duration requirements based on age and concluded that "Individuals who habitually sleep outside the normal range may be exhibiting signs or symptoms of serious health problems or, if done volitionally, may be compromising their health and well-being."[51]
These meditations were seen as being supported by the other elements of the eightfold path, such as the practice of ethics, right exertion, sense restraint and right view.[244] Two mental qualities are said to be indispensable for yogic practice in Buddhism, samatha (calm, stability) and vipassanā (insight, clear seeing).[245] Samatha is the quality of a stable, relaxed and calm mind. It is also associated with samadhi (mental unification, focus) and dhyana (a state of meditative absorption). Vipassanā meanwhile, is a kind of insight or penetrative understanding into the true nature of phenomena. It is also defined as "seeing things as they truly are" (yathābhūtaṃ darśanam). The true nature of things is defined and explained in different ways, but an important and unique feature of classical Buddhism is its understanding of all phenomena (dhammas) as being empty of a self (atman) or inherent essence, a doctrine termed Anatta ("not-self") and Śūnyatā (emptiness).[246][247] This is in sharp contrast with most other Indian traditions, whose goals are founded either on the idea of an individual soul (atman, jiva, purusha) or a universal monistic consciousness ( Brahman). Vipassanā also requires an understanding of suffering or dukkha (and thus the four noble truths), impermanence (anicca) and interdependent origination.

Similarly, Brahma sutras – the foundational text of the Vedanta school of Hinduism, discusses yoga in its sutra 2.1.3, 2.1.223 and others.[121] Brahma sutras are estimated to have been complete in the surviving form sometime between 450 BCE to 200 CE,[122][123] and its sutras assert that yoga is a means to gain "subtlety of body" and other powers.[121] The Nyaya sutras – the foundational text of the Nyaya school, variously estimated to have been composed between the 6th-century BCE and 2nd-century CE,[124][125] discusses yoga in sutras 4.2.38–50. This ancient text of the Nyaya school includes a discussion of yogic ethics, dhyana (meditation), samadhi, and among other things remarks that debate and philosophy is a form of yoga.[126][127][128]
If the meaning of yoga is understood as the practice of nirodha (mental control), then its goal is "the unqualified state of niruddha (the perfection of that process)",[147] according to Baba Hari Dass. In that context, "yoga (union) implies duality (as in joining of two things or principles); the result of yoga is the nondual state", and "as the union of the lower self and higher Self. The nondual state is characterized by the absence of individuality; it can be described as eternal peace, pure love, Self-realization, or liberation."[148]
Samuel states that Tantrism is a contested concept.[182] Tantra yoga may be described, according to Samuel, as practices in 9th to 10th century Buddhist and Hindu (Saiva, Shakti) texts, which included yogic practices with elaborate deity visualizations using geometrical arrays and drawings (mandala), fierce male and particularly female deities, transgressive life stage related rituals, extensive use of chakras and mantras, and sexual techniques, all aimed to help one's health, long life and liberation.[182][265]
One of the best known early expressions of Brahmanical Yoga thought is the Yoga Sutras of Patanjali , the original name of which may have been the Pātañjalayogaśāstra-sāṃkhya-pravacana (c. sometime between 325 - 425) which some scholars now believe included both the sutras and a commentary.[129] As the name suggests, the metaphysical basis for this text is the Indian philosophy termed Sāṃkhya. This atheistic school is mentioned in Kauṭilya's Arthashastra as one of the three categories of anviksikis (philosophies) along with Yoga and Cārvāka.[130][131] The two schools have some differences as well. Yoga accepted the conception of "personal god", while Samkhya developed as a rationalist, non-theistic/atheistic system of Hindu philosophy.[132][133][134] Sometimes Patanjali's system is referred to as Seshvara Samkhya in contradistinction to Kapila's Nirivara Samkhya.[135] The parallels between Yoga and Samkhya were so close that Max Müller says that "the two philosophies were in popular parlance distinguished from each other as Samkhya with and Samkhya without a Lord."[136]