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Signs it is time to increase your dose: You have been at the current dose for at least four weeks (the minimum) Weight loss has plateaued for two to three consecutive weeks Appetite suppression has noticeably diminished You tolerated side effects well and they have largely resolved You are not yet at your target weight or metabolic markers Signs you should stay at your current dose: You are still losing weight at a satisfactory rate Appetite suppression remains effective Side effects are present but manageable and still improving You have been at this dose for less than four weeks Signs you should decrease your dose: Side effects are severe and not improving after two to three weeks Nausea or vomiting prevents you from maintaining adequate nutrition You are losing weight too rapidly (more than 1 to 1.5% of body weight per week consistently) You are experiencing concerning symptoms beyond typical GI effects Weight loss that is too rapid can lead to gallstone formation, excessive muscle loss, and nutritional deficiencies