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During the first 2 to 4 weeks, you may experience: Nausea : Often most pronounced after meals, typically improving over time Reduced appetite : You may feel full more quickly and have less interest in food Mild abdominal discomfort : Bloating or a feeling of fullness Altered bowel habits : Either constipation or loose stools Fatigue : Some patients report tiredness as their body adjusts These effects are generally mild to moderate and tend to diminish as your body adapts to the medication