★ "What Worked For Me" Outcome Report @MaintenanceMode_WA • 45–59F • Tirzepatide 5 mg q10d • Week 52

▲ 82 Helpful • 2 Peer Replies

Once you reached your goal weight and A1C target on a GLP-1, what did your long-term maintenance plan look like?

I hit my goal weight (down 52 lbs, BMI 23.4, A1C 5.2%) four months ago after a year on Tirzepatide. My endocrinologist and I wanted a sustainable maintenance plan that prevented rebound hunger without continuing to lose weight. Instead of stopping abruptly—which the SURMOUNT-4 trial showed leads to ~14% weight regain as incretin signaling drops—we stepped down from 7.5 mg weekly to 5 mg every 10 days while increasing my daily maintenance calories by 350 kcal (mostly complex carbs and olive oil around workouts). Four months into maintenance, my weight has stayed within a 2-lb window and my triglycerides/ApoB are the best of my adult life. For others in maintenance mode, are you spacing shots out, stepping down in dose, or transitioning to Metformin ER?

⚕ Pinned FDA / NIH / PubMed Clinical Context • Nourhan Mansour — Literature & Label Auditor

In the SURMOUNT-4 randomized withdrawal trial (JAMA 2024), continuing tirzepatide maintained an additional 5.5% weight reduction over 52 weeks whereas placebo switch resulted in 14% weight regain. Gradual dose step-down paired with resistance training and high-satiety protein intake is the clinical standard for maintenance.

Connected Clinical Guides: Condition: Obesity Condition: Type 2 Diabetes Rx: Tirzepatide Rx: Semaglutide Rx: Metformin Supplement: Creatine Monohydrate Supplement: Psyllium Husk Fiber

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Verified Peer Replies (2)

@CanyonCyclist_UT • 45–59M • Tirzepatide 5 mg q10d • Week 56

Every 10 days on 5 mg has been the sweet spot for me for the past 5 months. It stretches a 4-pen box to almost 6 weeks (which helps a ton with out-of-pocket costs) while keeping inflammatory joint pain and food noise away.

@SteadyGlucose52 • 45–59F • Metformin ER 1,000 mg • Week 48

When my insurance stopped covering Wegovy after my BMI dropped below 25, my doctor transitioned me onto Metformin ER 1,000 mg at dinner ($5/month at Cost Plus) plus 30g fiber/day. I kept 90% of the weight off over the last 8 months.