Short answer first, then the reasoning. The line between titrate-through and stop is not severity, it is trajectory and what else is present. Nausea that peaks and improves within a week is the expected pattern. Nausea that is escalating, or that comes with severe upper-abdominal pain radiating to the back, or that prevents fluids for more than a day, is a different conversation and belongs with a clinician the same day.
The nausea I get is not really nausea, it is an aversion. Food I want in the abstract becomes repellent in front of me, which no side-effect list describes.
The narrow version of the question is what distinguishes the nausea you can titrate through from the nausea that means stop.
If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
mike_nyc said:The line between titrate-through and stop is not severity, it is trajectory and what else is present.
Agreeing with mike_nyc, and the qualification matters more than the agreement. 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.
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View Resultscarl_compliance said:The nausea I get is not really nausea, it is an aversion.
This matches mine closely enough to be worth saying so. 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.
Clinical perspective, offered as context rather than as advice. It is worth asking what the claim would look like if it were false. If nothing would look different, it is not a claim about the world and no amount of discussion will settle it.