Are you taking it now?  If so I would follow whatever dosing schedule you were given.

If you haven't started it be aware that the weight comes back if you stop so be prepared to take it for the rest of your life.

Red is not 100% true, but it does happen many times.

I have a family member and have had patients take it. While on it, you will change your eating habits (or barf/shit). You will also likely lose enough weight to make exercising easier/more comfortable. The trick is to keep the new eating habits and keep up with the new exercise regimen after stopping the drug.

You will still potentially gain some weight back once the drug is stopped, but if you make the changes (and, frankly, many of the successful people make the changes while on the drug because of the high out of pocket cost), you can still end up with a net loss of 50-75% of the peak weight loss.

Those that don't capitalize on the opportunity, will nearly certainly gain back every bit lost.

An issue some folks run into is availability. I've known people who have not been able to obtain it for so long they have to "re-start" at the beginning dosage. That has got to suck, especially as expensive as it is.

My suggestion would be to modify your diet for a while to reduce any triggers of your IBS as well as avoid foods that give you problems.  If the symptoms remain then they are likely drug-related.

If you actually don't know what things cause you problems then you might consider reducing your dose.  Most adverse drug effects (aside from allergic and idiosyncratic reactions) are dose-related so if you reduce your dose without changing your eating habits and the symptoms lessen, it is probably the drug.

Muscle mass is first to go so you may want to take some CJC 1295 with it.
I don’t  know why people don’t just exercise and control their intake.
Total lack of discipline.  
But, if it’s  you, here you go.
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I guess what I am suggesting is that you do an experiment to determine the cause.  In an experiment you vary only one variable at a time.  In this case either eat what you want and decrease the drug dose or avoid potential triggers and keep the dose constant.

In your case it doesn't sound like you have any particular triggers so the most direct test would be to decrease the dose and see if you still get the therapeutic effect but reduced GI symptoms.  

As a general rule pretty much all drugs have an optimal therapeutic window where they produce the desired effects.  Too little drug and you don't reach sufficient tissue concentrations for the drug to be efficacious. In contrast going too high usually doesn't increase efficacy or if it does it isn't worth the increased likelihood of adverse effects.  Adverse effects can be either an outgrowth of the drugs desirable effects or it can due to "off target" effects on other systems.   The lowest effective dose is almost always the best course when trying to reduce undesirable effects.  

Avoiding alcohol is probably just because alcohol has a pretty high caloric content but little nutritional value more than a specific interaction with the drug.  

My Dr. suggested I try it for a limit of three months .

Pain in the ass to find , fairly expensive.

Some constipation , some low level nausea .

Did lose some weight , did gain some of it back after stopping .

I do not recommend .

Life changer for me

2/5/24 was my one year anniversary at the clinic I go to. I’m down 75 lbs even. I had been weighing in even lighter a couple days Before I went to the clinic to get my injection but although I have been keeping records I only count the Monday morning weigh in as the official one

went to a separate facility to get my InBody body composition scan next. Out of 75 lbs, 10 was muscle mass and as I documented in the thread, that was lost in the first 3 months where I dropped 40 pounds almost too quickly. In the last 8 months I have lost zero lean muscle mass. The hard particulars? I started at 324 and Monday was 249
Went through a very nasty breakup in the fall - don’t ever discount the effects of personal stress and cortisol on sabotaging a program- between July and December I only had a net weight loss of 6 lbs, but have dropped 15 since December 18 (last court appearance was Dec 7 - hmmmm)

I’m not stopping and have shifted my goal from 225 (A weight I was formerly quite Lean at) to 200. Being 225 and lean was over two decades ago the 10 pounds of lost muscle mass won’t magically reappear —-

pics below on the right are from Jan, 2023. I wore the same hat and found a similar buffalo plaid shirt . The bike pic is me finishing the Hotter Than Hell hundred in August and I was probably weighing between 265 and 270 and I am likely around 280 in the motorcycle pic

At 249 , If I am to be brutally honest with myself , I’m still looking pretty haunchy , But it’s a dramatic improvement over the pic on the right from around the time that I started

I am amused to think that if I hit 225 I’m not eligible to race Clydesdale class in my local mountain bike series and I hope to hit that in two or three months. It’s irrelevant because I’m racing Cat 2 e-bike class though, but Will still be a fun mile stone to hit

It’s not an easy program or a quick fix for me because my body had reached a state where it just didn’t wanna cooperate at all. Cheat days will also punish me unmercifully at the scale, but I like the discipline. The diet took a lot of experimentation but to get this to work I’m probably 75% carnivore and thanks to some supportive friends who are avid deer hunters I have a freezer full of lean venison So it’s been the backbone of my diet program (venison stew, venison chili, bison burgers etc)
When I reached that big sticking point for a few months I finally had to drop all my pride and say “ how bad do you want this“

So with 50 pounds to go I’m a bit over the halfway mark. This goes hand-in-hand with cycling because cycling is all about suffering, and suffering is life.

No worries

Not in maintenance mode yet -- still have 50 lbs to go -- but i maxed out on straight semaglutide injections at 2.5ml and right now i am taking tirzepatide at 5ml  (i think) which is mounjaro.   Unlike your buddy, i actually like exercising and my increased food requirements have probably slowed down my progress, as i genuinely thought i had a chance of losing more in a years time --- but as i detailed above - my fall season sucked hard on a lot of levels

But i think exercising, even if its mostly aerobic - and the extra food i have needed for that (its still not much) likely helped me minimize the muscle loss so far --- i'll update the thread or edit this post later tonight when i can comment further on side effects and foods i have settled on after a lot of experimentation -- trying to get out of the office now --- but i have experienced most of the common side effects and still told myself -- "If its working, i'll deal with it"

Prior to starting the semaglutide program i was dabbling with a keto type program -- i was warned that if i stuck with keto and the medicine at the same time, i would run into serious low blood sugar issues because i am not diabetic.    The medicine lowers your blood sugar as it was originally intended as a diabetes medicine so if you are eating low carb at the same time it will really mess you up at first.

I would try to get in miles on my bike and start getting lightheaded and dizzy.    -- because i thought - well, i'll still eat low carb, but if i start feeling weird i'll eat a banana.   That was a no go philosophy.   First 3 months i lost weight pretty fast , which is typical of any diet i think, but i had cheat days where i would eat a slice or 2 of pizza, or hit a mexican restaurant for some enchiladas ---  the amount of food your stomach can process is greatly reduced so if i go to a mexican place , -- i skip the chips and tortillas and just order 2 enchilads (or 2 tacos or whatever) ala carte - because thats all you can process

Before, i could down a medium pizza on my own, and a mexican meal meant chips, queso, tortillas, the main entree and a couple of beers and maybe a margarita.   I didnt do that frequently, but it was within the realm of possibilities.   And a party day could mean 8 beers can get consumed over the course of a day ---  now if i am going full throttle and drink 3 - i pay the price, but alcohol in moderation is okay.

I didnt have energy for much, and still dont - riding the bike is drudgery and weight training is miserable, but im preparing myself for the day i lose some muscle mass again, it will be time for some more serious strength training, even if it slows down the total gross weight loss

The woman who turned me onto this medication and clinic lost 40 pounds with zero side effects.  She is a older person (65 i think) and while not sedentary, she just does typical old lady stuff like futz around in her garden and do volunteer work with her church, -- she's not trying to turn any numbers on a mountain bike or walk half marathons or anything .   She is on her maintenance dose now and has been holding steady for months

Me on the other hand, -- when i first started taking the medication -- the day i would get the shot i quickly learned to just write that day off -- no work, no gym time, no cycling -- i never got the shits, but nausea and dizziness were factors.   Im self employed so figuring out ways to work around it were not too bad for me, -    

Now that im a year in, i am back to eating very low carb - almost none but my body has adjusted to the program.   but i do keep clean fast acting carbs like fruit around .  It is amazing how fast a couple of bananas can level me out if i am feeling weird.   Salt too.   One of my quick fixes when i am feeling sodium depleted is chicken bone broth with a heavy dose of sea salt.    

    Leafy and cruciferous veggies and things like peppers do not process well for me now that i am taking this stuff either.   I recognize the need for essential vitamins and nutrients from veggies, so drink vegetable juice.   I avoid stuff like V8 and get the stuff from Sprouts or Whole Foods that costs too much, but when you look at the ingredient labels, V8 juice has twice as many unpronouncable ingredients

     Initially i was also eating plenty of cheese for snacks and things - typical keto diet stuff ---  but for the last few weeks i have predominately cut out all dairy also.     I dont bring stuff home with me and i will admit human frailty by saying i have had party nights where nothing sounds better than some nachos while i am watching Supercross or a football game -- these decisions are usually alcohol influenced.
   Stuff like that is fine once in a while --- but any leftover chips the next morning i feed to my pigs or just toss them -- theyre pretty fat too and dont need junk food either.       I never gave up beer , but as mentioned - im down to being satisfied with drinking one fancy shitbird beer snob beer, rather than drinking 6 Miller lights.   Alcohol is processed by your body slower too so it stays in your stomach longer and has a longer more drawn out effect

  Im outlining my experiences , but also stating that you may be like my friend the church lady and have very minimal side effects.

For me, going to a clinic to have the shots administered has been crucial to my success.  The clinic is run by a bunch of RN's and Nurse practitioner that oversees them, so when i go in weekly for my weigh in and shot, i can convey to them what i am feeling and they will tell me their theories on what is going on (eat more carbs if im low on sugar, or suggest that im sodium depleted, etc.  )  they also adjust my dosage up if i hit a sticking point .      My "before" picture up there would suggest that im not a heavy discipline type of operator, much as i would like to think i am ---  ive had to cope with the fact that i am who i am, and if having a support network of lady nurses and cycling coaches i consult with keeps me on the straight and narrow, then so be it.

     People have pointed out to me that my program "sounds expensive" (basically $400 per month ) -  but i am quick to point out that decreased beer consumption probably saves me $200 of that, plus Sunday mornings it used to be common to take my harley out for brunch with a bunch of like minded bike enthusiasts -- a bloody mary and an appetizer can it 50 bucks pretty quick so thats another $200 a month , and i pack my own lunch in the event i go to my office so i dont hit up restaurants for lunch.    My break up last fall sucked and i havent met anyone new yet, so i dont spend money on date night meals, and my refrigerator and pantry now looks like a monk lives in my house or something   -  so i am guessing the savings in those areas more than cancels out the cost of the medicine

     If i only had 30 or 40 pounds to lose, i wouldnt do this but i was in a pretty bad place --     So for me its been a life changing process

I can still go up on the mounjaro-  I think 2.4 ml was close to maxed out on the straight semaglutide but I’m trying to keep the numbers on the scale moving at the current dose as the next higher dose costs a bit more, which I can justify by the savings I talked about, but it’s still irritating

My counterpart who turned me onto this, her maintenance mode is that she still takes a shot but she only gets one once a month not once a week

That cost does not sound bad at all