lessthanhalf
Explorer
The plan you're considering likely isn't wise. Solid evidence that GLP medications lose their effectiveness for weight loss and appetite suppression over time is basically absent, aside from a handful of uncommon anecdotal reports. What we do have solid evidence for is tolerance developing to the adverse effects of GLP drugs — things like delayed gastric emptying, nausea, other gastrointestinal symptoms, and elevated heart rate. Because of that, when someone pauses and then resumes, they do need to begin at lower doses and work the dose up slowly.
One study in rodents found that semaglutide's effectiveness dropped when it was repeatedly stopped and restarted, and the animals put weight back on during the off periods. Human studies along these lines don't exist yet, but a number of people on this forum have posted about experiencing exactly that — the drug seeming weaker after a restart. So oddly, and without any clear mechanism I can point to, it may be possible to build tolerance to the weight-loss effects of GLP drugs through cycles of stopping and starting.
Based on what I've observed, the best case is that you'd need the same dose you were taking before the pause for a few months, and the worst case is that dose wouldn't work as well as it did prior to stopping.
Once you reach your target, the most straightforward and safest strategy is to lower the dose slightly and monitor your hunger and whether weight begins creeping up. If the reduced dose doesn't hold off regain, you'd need to increase it again; if you're still losing when you don't want to be, you'd lower it further. Context matters too, I think — if you've dropped a large amount of weight and dealt with long-term obesity, then realistically you'll almost certainly need to remain on these drugs at whatever dose works. If the weight issue was milder, more recent, or situational, then perhaps they won't be necessary.
When the obesity was significant, continuing the medication is a good move for long-term health overall. The more obese someone is, the older they are, or if they have obesity-related conditions such as high blood pressure, high blood sugar, or high cholesterol, then staying on higher doses is probably wise to head off long-term problems like heart disease and numerous other illnesses that become far more likely in that situation.