The maintenance dose, and why it is not always the top of the ladder

Every GLP-1 label has a ladder, and people read the top rung as the target. It is not. The maintenance dose is the step where weight is moving, blood sugar is where it should be, and the side effects are something you can live with. Some people get there at 1 mg. Others need 2.4 mg. The label gives the ceiling. The prescriber picks the floor.

Maintenance doses by drug

How long maintenance lasts

Obesity treatment on these drugs is designed to be long term, in the same way that blood pressure treatment is. The clearest evidence is what happens when it stops. In the STEP 1 extension, people who came off semaglutide regained about two thirds of the weight they had lost within a year. In SURMOUNT-4, people switched from tirzepatide to placebo regained a large share of what they had lost over the following year, while those who stayed on kept losing a little more. That is not a reason never to stop. It is the reason stopping is a plan, not an event. We cover it on the stopping page.

Dropping a step on purpose

Stepping down is normal. Reasons prescribers do it: side effects that never settled, weight at goal and the aim is holding rather than losing, a change in cost, or a plateau where the higher dose was not adding anything. The Wegovy label itself names 1.7 mg as a fallback maintenance dose. Some people on tirzepatide hold at 5 mg indefinitely. None of this is failure. It is the dose doing its job.

What maintenance looks like in the log

Month one is about tolerating the drug. Maintenance is about noticing drift. The questions that come up at the six month and twelve month reviews are slower ones: is weight holding, has appetite crept back, has protein intake slipped, is sleep worse, did HbA1c move. A dose log with a flat dose and a weight line is the first half of that picture. On Premium, Oura, WHOOP, Garmin, Apple Health or Health Connect fills in weight, sleep and heart rate, and a lab PDF fills in the bloodwork, all against the same weeks. Remi reads that and answers the question "what changed in the month my weight stopped moving" with dates.

Logging on Peptide AI is free, and that includes GLP-1s. The dose log, the titration schedule, vials with doses remaining, injection sites with a rotation reminder, nutrition, supplements and training are all on the free tier with no card. Premium adds bloodwork, Oura, WHOOP, Garmin, Apple Health and Health Connect on the same timeline, the body scanner and Remi, the coach that answers from your own log. The pricing page has the three plans.