newstart_MO 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 for spelling out the reasoning rather than just the conclusion.

Clinical perspective, offered as context rather than as advice. Start from the measurement rather than the conclusion. Almost every disagreement here turns out to be two people measuring different things and comparing the numbers anyway.

carl_compliance said:

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

This is where I part company with the consensus forming above. 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.

One concrete data point for the thread. 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.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Carry on.