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Circumstances in which a dose reduction or temporary pause would typically be considered include: Persistent nausea or vomiting that significantly impairs oral intake or daily functioning Severe diarrhoea lasting more than 48 hours, particularly if associated with signs of dehydration such as dizziness, reduced urine output, or dry mouth seek clinical review promptly if you are unable to keep fluids down Acute illness , surgery, or hospitalisation, during which metabolic demands and oral intake may be unpredictable Pancreatitis symptoms , including severe upper abdominal pain radiating to the back, which warrants immediate medical review Peri-operative considerations: UK guidance from the Centre for Perioperative Care (CPOC) and the Association of Anaesthetists advises that GLP-1 receptor agonist class medicines should be withheld before surgical procedures due to the risk of delayed gastric emptying and aspiration

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Documenting comorbidities such as cardiovascular disease, sleep apnea, type 2 diabetes risk factors, or obesity-related joint disease strengthens your case