PharmD_Rodriguez said:Extending the interval and reducing the dose are pharmacologically different.
The regain framing needs pushing back on. Two thirds regained means one third did not, and the trial provided no ongoing support to either group. Treating regain as pharmacologically inevitable is as unsupported as treating maintenance as automatic.
pam_stl said:I am eight weeks into deliberately reducing rather than stopping, and the appetite change came back faster than the weight did.
pam_stl said:...the STEP extension data on maintenance dosing is concerning...
Let me offer a different interpretation of the same data. Yes, 2/3 of weight was regained after discontinuation. But consider:
- This is consistent with EVERY chronic disease medication ever studied
- 1/3 of patients maintained significant weight loss — who are they and why?
- The metabolic improvements partially persisted even with weight regain
- The data supports long-term treatment, not a "course" of therapy
The takeaway isn't "the drug fails when you stop" — it's "chronic diseases require ongoing treatment." We've always known this.
Dr.LipidDallas said:The regain framing needs pushing back on.
Pregnancy after maintenance dosing weight loss: stopped GLP-1 medication 3 months before TTC as recommended. Was terrified of regaining weight during pregnancy.
Worked closely with my OB and MFM. Gained 26 lbs during pregnancy (within recommended range). Baby is healthy. The metabolic improvements from pre-pregnancy weight loss gave both of us a healthier pregnancy.
If you're planning pregnancy, discuss the medication discontinuation timeline with your OB. GLP-1 agonists are NOT safe during pregnancy.
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Shop Reference StandardsOne thing that is still open after JessicaM_2024’s answer:
Whether there is a lowest maintenance dose with actual maintenance data behind it, or whether everything published sits at the top of the ladder?
OP back with an update, since a thread like this is useless without one.
I went to a lower dose rather than a longer interval on the strength of the trough argument in this thread, and the difference in how even it feels is obvious.