Posting this as a warning rather than a discussion, and I will edit the post if any of it turns out to be wrong.
The nausea I get is not really nausea, it is an aversion. Food I want in the abstract becomes repellent in front of me, which no side-effect list describes.
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.
What to check: Trial-level incidence runs roughly 20 to 25% for nausea at the higher dose tiers and 12 to 17% for diarrhoea, with most events mild to moderate and concentrated in the weeks after each escalation.
If your experience contradicts this, say so in the thread — I would rather be corrected here than have people act on a warning that does not hold.
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.
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View ResultsTaking 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.