hans_munich said:Extending the interval and reducing the dose are pharmacologically different.
Thank you for spelling out the reasoning rather than just the conclusion. Printing the relevant bit and taking it with me.
Adding the clinical framing, because it changes how the question reads.
DerekSJ_a1c said:...I stopped maintenance dosing and regained all the weight...
This is a really important data point and I appreciate your honesty. The STEP 1 extension data showed ~2/3 of weight regain within 12 months of discontinuation.
This doesn't mean the drug "doesn't work" — it means obesity is a chronic disease requiring ongoing treatment, just like hypertension or diabetes. We don't criticize blood pressure meds for "not working" when BP rises after stopping them.
The framing matters. maintenance dosing is a treatment, not a cure. And that's okay.
TinaHashiRN said:The intervention that works is boring and well evidenced: resistance training two to three times a week at a genuine effort, protein at 1.4 to 2.0…
Pushing back on TinaHashiRN here. I think this board over-worries about lean mass. Some lean loss is obligatory — you need less muscle to move a smaller body, and preserving mass you no longer need is not a health outcome. The question is whether strength and function held, and mine did.
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Shop Reference StandardsDerekSJ_a1c said:STEP 4 is the study that answers this and it is blunt.
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.
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