SarahChen_PharmD said:

The nausea I get is not really nausea, it is an aversion.

No disagreement with SarahChen_PharmD. One condition attached. Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts. Receptor-level tachyphylaxis to the delayed-emptying effect develops over weeks while the central appetite effect persists, so the same dose is materially more comfortable at week six than at week two. A slower ladder therefore reaches the same dose with less cumulative nausea, not the same nausea spread thinner.

SarahChen_PharmD said:

The nausea I get is not really nausea, it is an aversion.

I dislike how confidently this board tells people to push through. Incidence figures around 20 to 25% at the higher doses are class-typical, but the trials also had a discontinuation column, and "manageable with protocols" is not the same as manageable for everyone.

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.

Dr.BariatricHTX said:

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

Adding a me-too, because a thread of one person's experience is not much use. Posting only so the count is not one.