mike.trainer_LA said:

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…

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.

Happy to go further on any of that.

One concrete data point for the thread. One practical note: write down what you did and when, before you need it. Reconstructing a timeline from memory three months later is how people end up unable to answer the one question that would have resolved it.

Dr.RaviCardio said:

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

Adding the part of the answer the thread has not reached. The honest answer is that the effect is real, the magnitude is contested, and the individual variation is larger than either. Those three things can all be true at once, and most arguments here are two people holding different parts of that.

That is the short version; the long version is somebody else's post.

One thing that is still open after EndoResFellow’s answer:

Whether holding at a lower dose for longer actually reduces total side-effect burden or just spreads it out?

OP back with an update, since a thread like this is useless without one.

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.