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Start titration exactly as recommended, because how quickly you escalate matters as much as what you change on the plate: Begin 0.25 mg once weekly for weeks 1–4 Move to 0.5 mg weekly for weeks 5–8 Continue gradual increases to your maintenance dose Pair careful titration with targeted, testable adjustments to meals, movement, and simple OTC supports to reduce the risk of severe gas and other GI symptoms as you adapt