This one has a reasonably settled answer, so here it is. 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 fat fraction of meals in the two days after dosing, and do not lie down straight after eating. Most of what people call unmanageable nausea is a meal-size and meal-composition problem interacting with a stomach that is emptying slowly.

Dr.LipidDallas 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…

That is correct as far as it goes, and here is where it stops going. The meal advice is right and incomplete without the hydration point. People stop drinking because drinking makes them feel full, then attribute dehydration symptoms to the drug.

tommy_boulder said:

Training four times a week throughout and the scale has barely acknowledged it, which is demoralising in a way I did not expect.

Agreed on adaptation, with a caveat: adaptation applies to gastric emptying and not to everything. If your problem is the aversion rather than the fullness, waiting does less, because the aversion is central and it is the mechanism working as intended.

Adding the clinical framing, because it changes how the question reads.

Exercise transformation with training: went from barely able to walk a block to completing a half marathon last Saturday.

My fitness journey alongside GLP-1 therapy:

• Month 1-2: Walking 15 min/day
• Month 3-4: Walking 30-45 min, started bodyweight exercises
• Month 5-6: Joined a gym, started resistance training
• Month 7+: Running, lifting heavy, cycling for fun

The weight loss made movement possible. The movement made more weight loss possible. Virtuous cycle in action.