I've been on the 0.25mg dose for the last month with very few side effects (a bit of nausea very occasionally) and have started on the 0.5mg dose today.
I read all the clinical trials first (on Medline/Pubmed - you can google them and read them too), and although some of the side effects can be uncomfortable, there are very few that are actually dangerous, and a lot of people don't have any.
Since the NHS only offers this to diabetics, I had to do it privately. Even though I've got a BMI of 43 and so am at high risk of diabetes (HBA1c mid range though so definitely not diabetic yet). But preventative medicine isn't something the NHS is good at sadly.
The thing that made me think I had to do something this extreme is listening to a podcast on BBC sounds given by the Van Tulleken brothers, identical twin doctors, one of who struggles with his weight. Part of the podcast was talking to various experts, including an obesity expert who said (and I might have got the numbers slightly wrong, but the basic point stands) that you have a 1 in 44,000 chance of getting from obese to a normal weight on a normal program of diet and exercise and staying that way for any length of time. Feel free to listen to it, it's eye opening.
So - obese for ever, with all that entails, or dangerous surgery, or a bit of cost and the odd bit of nausea - 🤔