Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about the maintenance and discontinuation question, and it is deliberately narrow — everything I am not confident about is marked as such.
What is actually established
STEP 4 is the study that answers this and it is blunt. Participants who continued kept losing; participants switched to placebo regained about two thirds of what they had lost within a year, and the metabolic improvements faded with the weight. That is the same pattern as every other chronic-disease medication ever withdrawn, and it is an argument about the condition rather than about the drug.
The condition it depends on
The caveat that "maintenance dose" in the literature almost always means the top studied dose. Lower maintenance doses are widely used and thinly evidenced, which is worth knowing before you cite anything as established.
What I am not sure about
What I am after is whether extending the interval works as well as reducing the dose, since they are not the same intervention pharmacologically. If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
— MikeFit_NJ · corrections welcome and will be edited into this post with credit