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I have been on Meridia 10 mg for approximately a week and a half. The only side effect that I have had is jittery sleep (i.e. I wake up a few times throughout the night and am very alert but can go right back to sleep - its odd! I am usually a VERY heavy sleeper) but this is no deal-breaker...Meridia has already been extremely effective - I have lost 6 pounds in a week and a half. I am about 40 lbs overweight so I still have a long way to go but it is such a relief that this is getting the ball rolling - the weight loss finally feels surmountable. Other reviewers are certainly correct - you do have to put in effort on this medication - it isn't a magic pill. I have stuck religiously to a 1200 cal diet & cardio for 30 min 5 days/week.