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Once at maintenance dose, weight loss continues at a slower, steadier pace. This is the most-comfortable phase clinically but the highest-cost phase financially.
Maintenance dose held weekly. Weight loss tapers from rapid (months 1-4) to gradual (months 4-12). STEP-1 averaged 14.9% at 68 weeks; SURMOUNT-1 averaged 20.9% at 72 weeks. GI side effects mostly resolve except mild constipation.
Muscle loss — track via resistance training, DEXA scan if motivated. Ensure protein intake 1.4 g/kg. Bone density in postmenopausal women. Hair shedding (usually temporary, weight-loss-driven).
STEP-5 (104 weeks Wegovy): weight loss sustained at ~15% through 2 years on continuous therapy. Discontinuation studies show rapid regain (~67% of lost weight back within 1 year off-drug).
Maintenance is when most patients ask "is this it forever?" The honest answer: probably yes, unless you sustain massive lifestyle change. Plan for long-term use or plan for cycling.
Editorial summary, not medical advice. Cycling, dose changes, and discontinuation should be coordinated with your prescriber.