Can you use both Tirzepatide and phentermine+topiramate combination at the same time?

Finally got an appointment with a Kaiser NP after “waiting” since June of this year. Started my journey on Sema, in Sept, then switched to Tirz in Dec with a med spa. I’ve lost 22 lbs so far with both. I kept the appointment with Kaiser in case I qualified for insurance to cover the meds. Surprise, surprise, “they are unsure what will happen Jan 1” however, the NP (nurse practitioner ) said I have to stop Tirz in order to start the phentermine+ topiramate combo. She then told me I would likely only loose the 130+ lbs with weight-loss surgery only, and that both tirzepatide and phentermine+topiramate combo I’ll only achieve a max of 14% body weight loss. So confused. I did ask if there are any contraindications for use of tirzepatide and phentermine+topiramate and she said “no, not at all.” I don’t know what to believe here….I know, antidotally that with Tirz (and sema) people are loosing more than just “14%” of their weight. I am starting to feel discouraged and do NOT want to do weigh loss surgery. I am sorry if I offended anyone who did take the big step to get life saving weight loss surgery.