Some people have great results with sema. I kept it up for 9 months with compounded sema b/c I was sure it would work and I felt a lot of appetite suppression - no more binge eating a pizza when stressed, less snacking, easier to stick to my diet, etc. But, for me, the weight loss was slow, and some months, non-existent. I also had some side effects on the larger doses of sema - crazy constipation, some fatigue. I learned I couldn't take sema and have a solid work out that day or the next, so I had to plan around my fitness schedule. My med spa PA wasn't surprised at all and seemed to think this was good/average progress. When I started backing off sema and adding AP tirz, I felt the difference immediately - my energy was back, constipation was gone, no fatigue. Also, food noise has been greatly reduced, even on a smaller dose.