I was diagnosed with type 2 with an A1C over 10. My doctor started me at 0.25 mg weekly for a month, then increased to 0.5 mg. The first few weeks were rough. Full on nausea, early fullness, constipation, and fatigue. I learned very quickly that if I overate, even a little, I’d pay for it with bloating and sometimes vomiting.
Around month 2, my appetite changed dramatically. I stopped obsessing over food. My fasting glucose started dropping from the 180–220 range into the low 100s. By 3–6 months, my A1C had fallen into the 5–6 range and I had lost 30–100+ pounds over time.
The biggest adjustment was learning to eat smaller meals, prioritize protein, hydrate aggressively, and avoid greasy foods. Once I respected the medication instead of trying to eat normally on it, the side effects became manageable. I eventually stabilized on 1 mg weekly as a maintenance dose.