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It acts by slowing down the emptying of your stomach. That means that whatever you eat stays in your stomach for many hours. If you eat too much at night or something that is acidy or spicy it causes terrible heart burn and reflux/regurgitation. I take an omeprazole with sodium bicarbonate at bedtime to relieve the acid.
I eat a granola bar or a couple of eggs for breakfast then a small bowl of whatever is on offer for dinner and that's it. My stomach is never empty. Sometimes, if I want to have something spicy or acidy I will have it for breakfast. I've had a fajita for breakfast and I once had chicken parm for breakfast. Then I eat something easy for dinner.
The most upsetting side effect was the fact that I went from a daily bathroom guy to every three or four days. I was eating so much less and my body was making such good use of what I ate that I just didn't produce much. It can cause constipation but you need to avoid taking laxatives because you can become dependant. Just drink lots of water, eat lots of fiber, and walk a lot and you will be fine.
If you fight it it's going to make you miserable. If you lean in you will lose a lot of weight fast. I've lost so much weight so quickly that my body freaks me out a bit. When I'm sitting on the edge of the bed and look down at my legs I don't recognize them. I told someone a few weeks ago that I just wanted a little candy because I'm fat and she said, "No you're not."
On the plus side I mentioned to my doctor that I was getting shorter (in in my late 50s and went from 5' 10 1/2" to 5' 9 1/2" and he asked, "Your penis?" I said, "No, that's getting longer!" He laughed and said, "It was hiding." I've actually gained an inch and a half of useable penis. (That's a happy side effect.)