A reference post rather than a discussion. Corrections are the point; I would rather this be right than mine. It is about nausea, and it is deliberately narrow — everything I am not confident about is marked as such.
What is actually established
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.
The condition it depends on
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.
The practical version
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.
What I am not sure about
What I am after is what distinguishes the nausea you can titrate through from the nausea that means stop. I would rather have one careful answer than five confident ones.
— MariaRD · corrections welcome and will be edited into this post with credit