PharmHunterJen said:

A step that is uncomfortable at week two is frequently comfortable at week six with no change in dose, because the gastric-emptying component…

Thank you — that is the clearest version of this I have read, and I have read a lot of them. Printing the relevant bit and taking it with me.

Clinical perspective, offered as context rather than as advice. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.

NurseLeah_Nash said:

Dose escalation anxiety for titration: I was terrified to move from 0.5mg to 1.0mg based on horror stories in this forum.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. Pushing back on the anecdote-stacking. Twenty people reporting the same thing is twenty samples from the same self-selected pool, not twenty independent confirmations.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

Adding the numbers, since they settle part of this. One habit that pays for itself: post the method alongside the number. A figure without its method cannot be checked, and an unchecked figure is how this community accumulates folklore.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. Carry on.