the gastric side effect list is the one most people encounter in the first two to four weeks at each new dose level - nausea, burping, and stomach discomfort are the early adaptation signals rather than a sign that the medication is not tolerated. the practical protocol for managing that window is small meals, high hydration, no high-fat or high-volume meals around dose day, and giving each new dose level two to three weeks before concluding the side effects are persistent