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Gastrointestinal symptoms are typically the most prominent and may include: Severe nausea and vomiting that persists despite usual remedies Intense abdominal pain or cramping Diarrhoea which may worsen dehydration Loss of appetite beyond normal medication effects Bloating and feeling of fullness due to significantly delayed gastric emptying These digestive symptoms occur because semaglutide slows the movement of food through the stomach, and excessive doses amplify this effect considerably