195. GLP-1 Maintenance: What Do We Actually Know?
What happens after you’ve lost the weight you wanted to lose?
In this episode, I’m looking at what we actually know about maintaining weight loss with GLP-1–based medications. The evidence so far suggests that for most people, continuing treatment at the dose that produced their weight loss provides the best chance of maintaining that weight loss and its associated health benefits.
But what if staying on the same dose isn’t possible because of side effects, cost, access, or personal preference?
I break down what we’re learning from SURMOUNT-MAINTAIN and ATTAIN-MAINTAIN, including evidence that reducing tirzepatide to a lower dose or switching from injectable semaglutide or tirzepatide to oral orforglipron can preserve substantially more of the weight loss achieved than stopping treatment altogether.
We still have important questions about tapering, extending dosing intervals, and whether some people can eventually come off treatment successfully. But for now, the evidence suggests that if we need to reduce treatment intensity, maintaining some active treatment may be a much better strategy than simply stopping and waiting to see what happens.
Ultimately, maintenance is about finding the level of treatment that allows an individual to maintain the health benefits they’ve achieved—while recognizing that for many people with chronic obesity, ongoing treatment at their effective dose will be necessary.
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Taking the first step toward weight loss can feel overwhelming — but you don’t have to do it alone. I’ve created a curated list of my podcast episodes to gently guide you as you begin your journey.
https://www.sashahighmd.com/podcast-guide
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