Dr.NateNeph 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.

KristenIndy said:

Planning the end of this rather than the middle of it, which nobody around me seems to want to talk about while it is still going well.

Pregnancy after maintenance dosing weight loss: stopped GLP-1 medication 4 months before TTC as recommended. Was terrified of regaining weight during pregnancy.

Worked closely with my OB and MFM. Gained 28 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.

Dr.AddMedPHL said:

The regain framing needs pushing back on.

Maintenance phase reality on maintenance dosing: reached my goal 7 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.

Following on from RunnerRach — and this may be the naive question:

Whether there is a lowest maintenance dose with actual maintenance data behind it, or whether everything published sits at the top of the ladder?

Reporting back.

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.