Dr.ObesityMed said:

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

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.

The figures, for anyone assembling their own picture. Say what you would expect to see if you were wrong, before you look. It is a small discipline and it changes what you notice.

Dr.CardioMD said:

I dislike how confidently this board tells people to push through.

There is a second half to this that has not been said yet. Take it one variable at a time. Almost every unanswerable question in these threads is unanswerable because three things changed in the same fortnight, and no amount of subsequent argument can untangle them after the fact.

Following on from RegAffairsDC — and this may be the naive question:

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

Closing the loop on my own question.

Holding the step for six weeks instead of four did it. Same dose, same food, and the nausea that had felt like a wall turned out to be a timing problem.