Dr.NutriCornell said:

Dose-response modeling for tirzepatide: Emax model fitting to the STEP/SURMOUNT dose-finding data shows: Semaglutide: ED50 ≈ 0.6mg, Emax ≈ -18%, Hill…

Can confirm the pattern Dr.NutriCornell describes. 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.

One thing that is still open after Dr.RenalNash’s answer:

What distinguishes the nausea you can titrate through from the nausea that means stop?

wendy_avl said:

The meal advice is right and incomplete without the hydration point.

This is where I part company with the consensus forming above. The counter-case has not been addressed. Somebody upthread described the situation that does not fit, and the thread moved on rather than engaging with it, which is the failure mode this board is supposed to avoid.

wendy_avl said:

The meal advice is right and incomplete without the hydration point.

True, with the qualification that this is a self-selected group. The people for whom it did not work post less, and that shapes everything we think we know.

Moderator note: the sourcing question belongs in the vendor section and has been split out.