Adding the clinical framing, because it changes how the question reads.

tammy_FL 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.

TrialTracker_MD said:

mike_nyc said: ...I stopped maintenance dosing and regained all the weight...

All true, with one condition: that curve is for people who reached the dose on schedule. Anyone who slowed the ladder for tolerability is on a different, flatter curve, and comparing yourself with the published mean will make you feel like a non-responder when you are not.

TrialTracker_MD said:

mike_nyc said: ...I stopped maintenance dosing and regained all the weight...

This answered a question I did not know how to ask. Sending this to two other people who asked me the same thing last week.

Adding the clinical framing, because it changes how the question reads.

Maintenance phase reality on maintenance dosing: reached my goal 8 months ago and now I'm in maintenance. It's a different mental game.

During weight loss, the scale going down is constant positive reinforcement. In maintenance, the scale staying the same is... just... nothing. It's anticlimactic. The dopamine hit is gone.

What keeps me going: lab improvements, physical capabilities, how I feel, fitting in clothes I love, and the knowledge that regain happens when people stop being intentional. I'm staying intentional.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. No action needed from anybody.