Weight loss maintenance

The problem nobody advertises #

The withdrawal trials are unambiguous. In SURMOUNT-4, people who stopped tirzepatide after 36 weeks regained about half their loss within a year. Those who continued kept the weight off and lost more. STEP 4 showed the same pattern for semaglutide.

Obesity is a chronic, relapsing condition. The biology behind weight gain does not stop because the scales hit a number. This view is realistic, not pessimistic, and explains why maintenance deserves as much design as the weight loss phase.

Reviewing the maintenance plan #

Options include continuing a prescribed maintenance regimen or planning a change or stop after discussing benefits, risks and your preferences. Reaching a goal does not automatically require a lower dose. See licensed maintenance doses.

Withdrawal trials do not establish a universal taper or planned cycle of stopping and restarting. Avoid changing doses or intervals yourself. See planning a treatment change.

The habits which do most of the work #

• Protein anchor. 1.2 to 1.6 g per kg of target weight daily. Muscle drives your metabolism. Protein feeds your muscle. The protein guide has the practical detail.
• Strength twice a week. The single highest-leverage habit for keeping weight off.
• Weekly weigh-in, same time, same scales. Data without drama. A 2 kg uptrend is a signal, not a sentence.
• Sleep 7 to 9 hours. Short sleep raises ghrelin (hunger) and lowers leptin (fullness), a hormonal headwind you can simply remove.
• A plan for high-risk weeks. Holidays, Christmas, stressful quarters: decide in advance what "good enough" looks like.

Planning ongoing support #

Agree review dates, the health and weight changes to monitor, and how to contact your clinical team. Any return to treatment after a break needs a fresh prescribing decision. Local support, your GP and dietetic or psychological care may also form part of your plan.

The mindset to make maintenance last #

People who maintain best share one shift: they stop seeing maintenance as the absence of treatment and start seeing maintenance as the point of treatment. The medicine gave you a quieter appetite. Maintenance is what you built during the quiet period. Our life after GLP-1 guide covers the next stage in more detail.