Taking the question as asked, rather than the general version of it. 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.

InsuranceTom said:

The line between titrate-through and stop is not severity, it is trajectory and what else is present.

No disagreement with InsuranceTom. One condition attached. 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.

Dr.GastroMayo said:

Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts.

Can confirm the pattern Dr.GastroMayo describes. 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 helps to ask what evidence would change your mind before you look at any. If nothing would, the discussion is not about evidence, and it is better to say so early than to spend nine posts discovering it.