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Here are signs that your dose may need adjustment: Signs the dose is too high: Persistent nausea beyond 3 weeks at current dose level Regular vomiting (more than once per week) Severe constipation not responding to hydration and fiber Food aversion (inability to eat adequate nutrition) Rapid weight loss exceeding 1.5% of body weight per week Signs the dose is too low: No noticeable change in appetite or satiety Minimal or no reduction in food intake Weight has plateaued for 4 or more weeks No gastrointestinal effects whatsoever (some mild effects indicate the drug is working) Signs you are at the right dose: Moderate appetite suppression (eating less without feeling starved) Steady, sustainable weight changes Mild or no side effects Improved satiety (feeling satisfied with smaller portions) Stable energy levels throughout the day Finding the right dose is a process