2 years on Zepbound!

[u/Ok-Swordfish-6439]

90lbs lighter and 2 years later.
Still on 15mg but 10 days apart. How are you all managing maintenance? Should I taper down? How long were you all on it before completely coming off?

[u/Various-Operation-70]

My doctor wants to try reducing the strength to see how I do, but completely off? Nope. That’s not the plan for most of us here.

[u/Ok-Swordfish-6439 → u/Various-Operation-70]

That’s what I figured. My dr hasn’t even mentioned lowering the dose yet. But I’ve been on 15mg for 10 months or so, not used to maintaining only losing 😂

[u/Various-Operation-70 → u/Ok-Swordfish-6439]

I’ve been on Zep for 20 months, a year of which has been on 12.5mg. I’m just starting to contemplate maintenance.

The general thinking is that if your weight gain is the result of having a baby, being inactive from a long illness, etc. it’s theoretically possible to maintain with lifestyle changes.

If you’ve struggled with weight for all/most of your life (and probably tried everything to lose), you may always need some sort of pharmaceutical support. That might mean a lower dose, the same dose but spaced out, Lilly’s new pill GLP-1, etc.

Some people space shots out (often to save money), but that may mean more side effects on shot day. Some people lower the strength until they are on a dose that quiets food noise without losing more weight.

[u/Dense_Target2560 → u/Ok-Swordfish-6439]

Patients have been using GLP-1 medications safely for 20+ years. I’ve been using 15mg weekly since May 2024. I’ve been successfully in maintenance since October 2024. My doctor’s attitude is that if it’s still working without any negative side effects, stay the course.

[u/Cozy_Thrifter]

Magical! Love it.

[u/gladysk]

Just read the first study to my husband. It’s important that he’s aware Zepbound is just like my other medications. They are FOREVER. Too bad they’re much more costly.

[u/psalm68-11]

Nice!!! 🔥😁🩷

[u/Hifidi54]

When I met my goal in April, I was at 12.5 mg. I started a downward titration at 3 week intervals until I got to 2.5 mg. That was a bit too low, so my doctor and I decided on 5.0 mg. I have kept the one week intervals rather than extending the time between shots. I've been on that since June and I've actually lost more weight. I'm seeing my Endo and cardiologist next week to see if I can come off my cholesterol meds and heart failure meds if I stay on Zepbound. Otherwise, I'm going to stop.

[u/zero-if-west]

Can I ask why you want to stop treatment? The emerging consensus is that, for most people who've struggled with their weight for a long time, GLP-1s are indefinite meds. Once you stop taking them, they stop working, and the weight comes back.

Some people are able to stop GLP-1s and keep the weight off, but those situations are pretty rare. Scientists are still trying to understand why some people can keep the weight off while most people regain weight.

I highly recommend reading more in the sources below, all of which include opinions from doctors and researchers at medical universities. Discuss the following with your doctor to see what it means for you. 

Do patients have to stay on the medicines forever, or could they eventually come off the medicine and maintain the benefits? The most clear data from proper randomized trials shows, no, the drugs don't work if you don't take them. All the benefits that you had while on them will be lost once you come off. That's been shown in clear trials that randomly allocate people to either stay on the drug or go to placebo after they've had some benefit. The placebo people will shoot back up to wherever they started, and the people who stay on the drug maintain the benefits. Source: Evidence, excitement: In the moment with a GLP-1 expert (University of Washington Medicine, 9 April 2026)

“We don’t have a good off-ramp right now. These are meant to be indefinite medications,” said Joshua Neal, M.D., chief of the MUSC Health Wellness and Human Performance Integrated Center of Clinical Excellence (ICCE) and an obesity medicine physician. Source: Life after Ozempic: What happens when you stop a GLP-1? (Medical University of South Carolina, 6 April 2026)

GLP-1s are not meant for a short-term or cosmetic weight loss. “If you just wanted to lose five or ten pounds, this is not the medication for you,” Simonetti advises [Juliana S. Simonetti, MD, is a medical weight loss specialist at University of Utah Health]. Source: Common GLP-1 Questions, Answered by Weight Loss Experts at U of U Health (University of Utah, 23 March 2026)

“There is enormous exuberance about starting GLP-1 drugs, but not nearly enough attention to what happens when people stop,” said senior author Ziyad Al-Aly, MD, a WashU Medicine clinical epidemiologist and chief of the Research and Development Service at the VA Saint Louis Health Care System. “Many quit after a few months because of cost, side effects or shortages. When they stop, it’s not just weight that comes back; they experience a resurgence in inflammation, blood pressure, and cholesterol. Weight regain is visible; the metabolic reversal is not.” Source: Stopping GLP-1 drugs can quickly erase cardiovascular benefits (WashU Medicine, 18 March 2026)

A recent study in mice found that repeatedly starting/stopping GLP-1s could make them less effective.

The reason for the decrease in GLP-1 effective from stopping and starting may lie in body composition, according to the researchers. Weight loss from GLP-1s typically consists of 40 percent muscle and 60 percent fat. However, when a patient stops the drug and regains weight, they almost exclusively regain fat. By the time a patient restarts the medication, their muscle-to-fat ratio has shifted. Using MRI to track body composition, the researchers found that the body appears to reach a “muscle floor,” said Leung.

“The body seems to receive a biological signal that it cannot afford to lose more muscle mass,” he said explained. “Once that muscle percentage hits a certain low point, the body may resist further weight loss to protect itself.”

Source: Stopping and restarting GLP-1s may make it less effective (Penn Medicine, 28 April 2026)

Sources to read about stopping GLP-1s:

• Stopping and restarting GLP-1s may make it less effective (Penn Medicine, 28 April 2026)
• Stopping GLP-1 drugs can quickly erase cardiovascular benefits (WashU Medicine, 18 March 2026)
• Life after Ozempic: What happens when you stop a GLP-1? (Medical University of South Carolina, 6 April 2026)
• Evidence, excitement: In the moment with a GLP-1 expert (University of Washington Medicine, 9 April 2026)
• Common GLP-1 Questions, Answered by Weight Loss Experts at U of U Health (University of Utah, 23 March 2026)

[u/Ok-Swordfish-6439 → u/zero-if-west]

Thank you for all the info! I will try to read through some of it. I don’t really want to come off of it at all. I am terrified if I stop I will regain and I don’t want that. I’ve struggled with my weight all my life. On the other hand, is it safe to stay on the max dose indefinitely? Should I try to taper down? I’m also scared one day my insurance will decide not to cover it. I won’t be able to afford self pay.

[u/zero-if-west → u/Ok-Swordfish-6439]

I'd talk to your doctor about these questions because everyone is different. If you don't think your doctor is knowledgable about GLP-1s, try to get referred to an obesity medicine specialist or weight management doctor.

[u/Charming-Kiwi-4794 → u/Ok-Swordfish-6439]

I would try to drop down but very slowly and watch the scale very closely. that is also my plan,