week 4 on 2.5mg and my mate says jump straight to 10

Moderator here, stepping in because this one matters. Do not do what your gym friend suggested. Going from 2.5 mg to 10 mg is a fourfold jump in a single week and it skips the two dose levels the titration schedule exists to walk you through. The schedule is not padding. It is there because gastrointestinal side effects scale with how fast you escalate, and the unpleasant end of that is not "a bit of nausea", it is vomiting and dehydration serious enough to land people on a drip. There are also reports of pancreatitis and gallbladder problems associated with these drugs generally, and aggressive escalation is not the side of caution you want to be on. Your friend being fine tells you what happened to one person. It does not tell you what will happen to you. Second thing, and I say this as a moderator and not as anyone qualified: nobody on this forum, me included, should be handing you a dosing plan with confidence. This is a prescription medicine class. The titration schedule you described is the standard one and it is standard for good reasons, and a doctor who knows your history and bloods is the person who should be signing off on any change. Your own reasoning in the post is better than the advice you were given, for what it is worth. If the current dose is still producing the effect you want with side effects you can live with, there is no prize for climbing faster.

Seconding all of that. I stepped 2.5 to 5 to 7.5 over twelve weeks and sat on 7.5 for ages because it was working. Went to 10 eventually and the difference in appetite was honestly marginal for me, but the sulphur burps and the fatigue were not marginal at all. The oxtail lesson is real and you will relearn it about three more times. Fatty food plus this class of drug equals a bad night. Gastric emptying is slowed right down so a heavy meal sits there.

Thanks both. Staying on 2.5 for now, will move to 5 when the appetite effect starts fading rather than on a calendar. Have a GP appointment on the 20th anyway so I will raise it there.

Late to this but one practical thing nobody mentioned. Protein. At 111 kg cutting hard on a drug that kills your appetite, you will lose more lean mass than you want to unless you deliberately front-load protein early in the day while you can still face eating. I aim for most of my protein before 2pm because by evening the thought of chicken is unbearable. Shakes count. This is the single thing I would go back and tell myself.