Is there a lower maintenance dose once I reach my goal?

Patients reasonably ask whether they can drop to a lower dose once the weight is off. The labels allow some flexibility. The trials do not answer the question, and it is worth knowing that before you assume a lower dose will hold your result.

What the labels permit

Tirzepatide has three approved maintenance doses for weight management: 5, 10 and 15 mg weekly. All three are maintenance doses, not stepping stones, and in SURMOUNT-1 the 5 mg dose produced 16.0 percent weight loss in the efficacy analysis. Injectable semaglutide has a recommended maintenance dose of 2.4 mg weekly, with 1.7 mg accepted if 2.4 mg is not tolerated. Wegovy HD at 7.2 mg weekly was approved in March 2026 for patients who need more. Oral semaglutide maintenance is 25 mg daily.

What the maintenance trials actually tested

The two randomised trials of continuation both compared staying on a full dose against stopping altogether. In STEP 4, participants who completed a 20 week run-in and continued semaglutide lost a further 7.9 percent between week 20 and week 68, while those switched to placebo gained 6.9 percent, a difference of 14.8 percentage points. In SURMOUNT-4, continued tirzepatide at 10 or 15 mg maintained and extended weight loss while the placebo group regained. Neither trial tested a reduced maintenance dose. That gap is the honest answer to this question.

How a dose reduction is approached in practice

Where I do reduce, I reduce one step, hold it for at least twelve weeks, and watch weight, waist and appetite rather than assuming. Appetite returning within two to three weeks of a reduction is the signal that the lower dose is not holding. Side effects that were tolerable during weight loss but are unwelcome in maintenance, and the arrival of a stable weight with good metabolic markers, are both legitimate reasons to try a step down. Convenience alone is not, given what the withdrawal data shows.

If you want to trial a lower dose, agree three things with your prescriber first: which dose, how long you will hold it before judging, and the weight threshold that means you go back up. Drifting down a dose without those parameters usually ends as an unplanned discontinuation.