Long-term medical weight loss
Maintenance Guidance for Wegovy and Mounjaro
We are pleased to continue supporting you with your weight maintenance journey following successful weight loss with Wegovy (semaglutide) or Mounjaro (tirzepatide).
Weight loss medications are intended to support long term weight management alongside healthy lifestyle changes. As your weight stabilises, many people are able to reduce their medication dose while maintaining the benefits they have achieved.
Our Maintenance Approach
Our aim is to help you find the lowest effective dose that allows you to maintain your weight without experiencing excessive hunger or food cravings.
The goal during maintenance is for your weight to remain stable, rather than continuing to lose weight. Once you have maintained your weight for several months on a lower dose, you may be able to reduce the dose further. This gradual step-down approach can continue until you are ready to stop treatment, if appropriate.
Maintenance doses
Mounjaro Injection (tirzepatide)
The manufacturer recommended maintenance doses are 5mg, 10mg and 15mg once weekly.
Some patients may successfully maintain their weight on lower doses depending on their individual response.
Wegovy Injection (semaglutide)
The licensed maintenance dose is 7.2mg once weekly.
However, many patients are able to maintain their weight on a lower weekly dose.
Wegovy Pill (semaglutide)
The dose should be gradually increased in line with the recommended dose escalation schedule until the maintenance dose of 25mg once daily is achieved.
Treatment may also be continued at a lower dose to support maintenance.
We will work with you to identify the lowest effective dose that keeps your weight stable while controlling appetite.
Eligibility for Ongoing Maintenance Treatment
Before approving ongoing maintenance treatment or restarting medication following a treatment break, our clinicians will complete the necessary clinical and safety assessments to confirm that treatment remains safe, clinically appropriate, and suitable for you.
We are happy to continue prescribing treatment for maintenance even if your BMI falls below 30 kg/m², provided that:
- your weight remains within a healthy range,
- your BMI is not below 22 kg/m² and,
- you have been using your medication consistently on a weekly basis, with your most recent dose taken within the previous 2 weeks.
Stopping Treatment
The decision to continue long term maintenance treatment or gradually stop medication is an individual choice. We will support whichever approach best aligns with your health goals.
There are no known harmful medical effects associated with stopping Wegovy or Mounjaro. However, it is common for appetite and food cravings to increase after treatment is discontinued. This can make maintaining weight more challenging, particularly if healthy eating and activity habits have not yet become established.
For this reason, we recommend reducing the dose gradually where appropriate while continuing to focus on long term lifestyle changes.
If you decide to stop taking weight loss medication, maintaining your weight will depend on continuing the healthy habits you have developed throughout your journey.
- As your body weight changes, your daily calorie intake also changes, so it is important to recalculate your calorie intake to support weight maintenance rather than further weight loss
- Continuing to eat enough protein can help preserve muscle mass and keep you feeling fuller for longer, while staying well hydrated by drinking adequate amounts of water can also help with appetite regulation and overall health
- Regular physical activity, including strength exercises, remains an important part of maintaining your weight and supporting muscle mass
- Planning balanced meals, and recognising signs of increased hunger or weight regain can help you make small adjustments before they become more difficult to manage
Remember that fluctuations in weight are normal, and building sustainable habits around eating, physical activity and overall wellbeing can help you maintain your progress and support your long term health.
Restarting Treatment
Restarting treatment is only possible if:
- your last dose was taken within the last 6 months,
- your BMI remains 22 kg/m² or above,
- there are no new medical reasons why treatment would be unsuitable
If you decide to stop treatment and later wish to restart:
- Mounjaro Injection must be restarted at 2.5mg starting dose
- Wegovy Injection must be restarted at the 0.25mg starting dose
- Wegovy Pill must be restarted at the 1.5mg starting dose
Lifestyle Changes Remain Essential
Medication works best when combined with sustainable lifestyle changes. To help maintain your weight in the long term, we encourage you to:
- Eat a balanced, nutritious diet
- Continue regular physical activity, including strength exercise
- Prioritise adequate sleep
- Manage stress where possible
- Continue the healthy habits you developed during your weight loss journey
For additional support, we recommend the NHS Better Health 12-Week Weight Loss Plan (https://www.nhs.uk/better-health/lose-weight/), which provides practical advice for maintaining healthy habits.
Ongoing Support
Weight maintenance is different for everyone. Some people choose to remain on long term maintenance treatment, while others prefer to gradually reduce and stop medication. We will work with you to develop a plan that supports your long term weight management goals and overall health.
If you would like to discuss your options before making a decision, you can book a free video consultation with one of our trained clinicians. Appointments are available throughout the week, including daytime and evening sessions, giving you the opportunity to ask questions and receive advice before starting your maintenance journey.
Written by: Uzma Dala MPharm (2238839)
Approved by: Shameela Adam MPharm (2070113)
