1 lb weight loss after almost 3 months

I’m so frustrated. A single pound is all I’ve lost. I’ve been .25 for 4 weeks and increase to .50 for the last 8 weeks with awful nausea. I weighed today with the doctor and after a complete overhaul of my diet and increased exercise (as much as physically capable with a bad back) and only 1 pound. doctor says I can increase this week to 1 mg but given how nauseous I’ve been I’m a bit hesitant. At 280 lbs I could have probably taken laxative and lost more than a pound. This was my last chance and I’m so upset. I’ve had bloods done to check thyroid levels but they’ve been fine for the past 2 months so I doubt it’s that. I pay out of pocket and I can’t afford it if it’s not working. What can I do?? Handle this happens to anyone else? Did it eventually work? I feel like I’m paying to feel nauseated