Dr.ObesityLA said:

The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the…

I dislike how confidently this board tells people to push through. Incidence figures around 20 to 25% at the higher doses are class-typical, but the trials also had a discontinuation column, and "manageable with protocols" is not the same as manageable for everyone.

Adding the numbers, since they settle part of this. Practical: whatever you change, write down the date and the reason. In three months the reason is what you will have forgotten, and the reason is what makes the record worth having.

BethLabQueen said:

I dislike how confidently this board tells people to push through.

Coming at BethLabQueen’s question from a different direction. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

Following on from Dr.EndoEP — and this may be the naive question:

Whether holding at a lower dose for longer actually reduces total side-effect burden or just spreads it out?

OP back with an update, since a thread like this is useless without one.

Holding the step for six weeks instead of four did it. Same dose, same food, and the nausea that had felt like a wall turned out to be a timing problem.