"update to my post from march 30. i&#039;ve lost 15 lbs so far. the extreme fatigue has gotten much better as i think by body is adjusting. i&#039;m still only at a dose of 1.5 (1.2 plus 5 clicks) i am increasing the dose very slowly. if i go to quickly it makes me sick. if i only increase an extra &quot;click&quot; on the pen each week it seems to work well. i&#039;m very happy with this medicine. i&#039;ve just had to learn to go slowly. i have to pay attention to the last time i had a bowel movement. i&#039;m fine for 3-4 days with normal movements but then have to take a very mild laxative to help things along."