Which appetite suppressant should be avoided before and during pregnancy?

• A. Orlistat
• B. Topiramate
• C. Lorcaserin
• D. Phentermine

Answer: (B)

Teratogenic risk in pregnancy is the key consideration when deciding whether an appetite suppressant is safe to use. Topiramate has a well-established association with birth defects, especially neural tube defects like spina bifida, when exposure occurs in early pregnancy. Because of this clear fetal risk, it should be avoided before and during pregnancy. The other options don’t carry the same consistently documented teratogenic risk, so while safety data in pregnancy is limited and weight‑loss medications are generally used with caution, topiramate stands out as the one to avoid for this purpose.