DataDave said:

The OASIS programme put 50mg oral in the same territory as 2.4mg injectable — around 15% mean weight loss — but it needed a dose 20 times larger to…

I do not accept that the fasting window is a minor inconvenience. Adherence data on daily orals with timing requirements is consistently worse than weekly injections, and a drug you take imperfectly is a lower dose than the one on the box.

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.

BariatricNurseD said:

I do not accept that the fasting window is a minor inconvenience.

Coming at BariatricNurseD’s question from a different direction. It helps to say which part of this you are uncertain about. A precise question gets a precise answer; a general one gets everybody’s favourite anecdote.

One thing that is still open after jason_paloalto’s answer:

Whether the fasting requirement is as strict in practice as the label implies, and what people actually see when they get it wrong?

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

Follow-up: moving the tablet to the moment I wake, before anything else, was the whole fix. The dose never changed.