Semaglutide 1.0mg for maintenance — 12 month update

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

STEP 5 long-term data on maintenance dosing: the 104-week (2-year) extension showed sustained weight loss of -15.2% with continued semaglutide vs weight regain in the discontinuation group[1].

Key insight: weight loss continued to accrue between weeks 68 and 104 in many patients, suggesting the nadir may not occur until year 2+. The 68-week primary endpoint in most trials may underestimate maximal efficacy.

This supports long-term, open-ended treatment rather than fixed-duration "courses" of therapy.

Dr.PathRoch said:

Pregnancy after maintenance dosing weight loss: stopped GLP-1 medication 3 months before TTC as recommended.

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.

Clinical perspective, offered as context rather than as advice.

Dr.PathRoch 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.

Dr.RheumBOS said:

Dr.PathRoch said: ...the STEP extension data on maintenance dosing is concerning...

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

Moderator note: a couple of off-topic posts removed. Carry on.