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Its bigger, higher, through a different culture and you are much more likely to be on an organised trek.
The actual walking itself is probably no harder that at home. Trails tend to be reasonable. In a group you will probably have a porter team to carry your heavy bag, leaving you with a day sack only to carry.
The main difference is the altitude. Go steady, read everything you can to understand the physiological changes your body needs to go through and understand the symptoms of acute mountain sickness (AMS), high altitude pulmonary oedema (HAPE) and high altitude cerebral oedema (HACE). Look out for possible symptoms in trek-mates and yourself.
The other main challenge is likely to be staying fit and healthy in a totally different environment to home. Eat carefully, wash carefully and look after yourself is the best advice.
Our Nepal and India guides are full of more detailed, sound advice on this. Don’t be put off, however; nearly everyone adapts and has a great time amongst some of the world’s highest and most beautiful mountains (and people).
Before you go: