lessthanhalf
New member
It is a long way from definitively proven what doses are required for maintenance, and on this forum there are people maintaining on low doses. My belief that weight loss doses are required for maintenance is based on some evidence, plus my understanding of what is occurring physiologically in the plateau state. Where that dose of the drug balances out the weight regain tendencies of the weight lost state, ( reduced appetite from the drug versus increased hunger and reduced energy expenditure from weight loss ) which is why weight loss ceases at that point, where these forces are evenly balanced. So that reductions in dose then should tip the scales back towards weight regain.
My way of thinking about it is based on the graph of 4 years continuation of the drug after the initial 1 year study where the overall shape of weight over time is a flat line for the studied doses, and that stays flat for 4 years. Logically it suggests that that dose maintains the weight, at least on average, and does so for different doses. I am not sure there is much else really long term to go on at this stage. So my logical inference from the available data is definitely not gold standard clinical trial evidence, and much more specific and longer term studies are definitely needed.
One thing that confuses me is that pretty much every study I have seen about maintenance or plateaus is based on a <5% weight loss/gain over the previous 3 months, as their definition of a stable weight. Given that you could be starting on maximum dose semaglutide and losing weight at the average rate and still meet this definition, suggests to me that it is not really strict enough to capture plateau states accurately, which makes me question the results obtained.