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I think this is likely because it's not covered in Canada for weight loss, so upping dosages at a reasonable rate is too expensive

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Int J Obes (Lond) 40:13101319 Winslow DH, Bowden CH, DiDonato KP, McCullough PA (2012) A randomized, double-blind, placebo-controlled study of an oral, extended-release formulation of phentermine/topiramate for the treatment of obstructive sleep apnea in obese adults

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The exact mechanism is not fully understood, but gastrointestinal effects and possible changes to saliva composition may contribute to metallic, bitter, or unpleasant taste sensations

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