I lost a ton of weight about 10 years ago while taking phentermine and doing IF together. It made fasting so much easier. I suggest waiting until you are really hungry before you eat. (Stretch that IF window as long as you can, do OMAD if possible) Use the medication to your advantage as it is not good to be on it for long periods of time, but while you are on it you can definitely jump start your weight loss, and teach your body IF. I really believe if you use it correctly it can help you change your mind set about food and eating and allow you to lose the weight. You should see results quickly if you do it correctly. Best of luck with your journey!
If you need to take it with food, eat some lettuce with it.
At your size I think you will find OMAD to be pretty easy to do. If you fast clean (drink water, up to 1 cup of black coffee) during fasting times, I think you will find it’s effects pretty similar to phen. If you are getting bad side effects of phen, it’s something to consider.
I recommend the book Delay Don’t Deny. The author was on phen for a while and she talks about that.