Maintenance phase — 18 months at goal weight, labs still improving

anders_CPH said:

One third of STEP 4 participants held most of their loss without the drug, and nobody has convincingly characterised who they are.

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.

One concrete data point for the thread. Post reference ranges alongside numbers when you share them. Units differ by country — glucose and lipids especially — and half the confusion in these threads is unit mismatch rather than disagreement.

labquiet_amy said:

The regain framing needs pushing back on.

Adding the part of the answer the thread has not reached. A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin and B12, and a full blood count. That set catches the things that change, the things that explain symptoms, and the things that alter the prescribing decision. Almost everything else on the long circulating lists is either invariant, uninterpretable without a specific question, or an incidental finding waiting to cause an unnecessary workup.

A narrower follow-up, since the general answer is now clear:

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

OP back with an update, since a thread like this is useless without one.

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.