This one has a reasonably settled answer, so here it is. 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.

BariatricNurseD said:

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

Agreed on adaptation, with a caveat: adaptation applies to gastric emptying and not to everything. If your problem is the aversion rather than the fullness, waiting does less, because the aversion is central and it is the mechanism working as intended.

KristenIndy said:

I trained through the whole thing, three times a week, and the effect on the scale was almost nothing while the effect on everything else was large.

Can confirm the pattern KristenIndy 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.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

From the other side of the consultation, briefly.

Pet owner bonus of training: my dog is also losing weight because we're walking 2-3x more than before. His vet is thrilled. 🐕

We went from a 5-minute shuffle around the block to 30-minute walks through the neighborhood. He's more energetic, I'm more energetic, and we're both healthier.

Get a dog. Or borrow one. Walking a dog is the best low-impact exercise motivation that exists. They never let you skip a walk. 🐾