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This is a state where there is too much acid in the body fluids

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AACR, 2015

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Your body needs time to adjust to each: GLP-1 receptor: Slows gastric emptying, reduces appetite GIP receptor: Enhances insulin signaling, affects fat metabolism Glucagon receptor: Increases energy expenditure, promotes fat oxidation Jumping to high doses overwhelms these systems, causing: Severe nausea and vomiting Treatment discontinuation Longer overall time to reach therapeutic doses The data: In the Phase 2 NEJM study, participants who started at 4 mg instead of 2 mg had significantly higher rates of gastrointestinal side effects