GLP-1 Microdosing Doses: Reference Chart for Maintenance
What these dose tables show
You have reached your goal weight and want to stay there. Keeping the weight off requires a different approach than active weight loss. Full therapeutic doses were built for rapid reduction. Maintenance doses are built for stability, reduced side effects, and long-term management.
The tables below show reference ranges for how patients typically transition to maintenance dosing. Your provider may recommend a dose anywhere within these ranges, or outside them, based on your individual response and health history. These are not prescriptions or recommendations. Your provider determines your dose.
Semaglutide maintenance dose reference
Semaglutide is a GLP-1 receptor agonist approved for weight loss at doses up to 2.4mg weekly. The active weight loss protocol escalates doses over 16 weeks to reach that maximum.
Once you reach goal weight, the question shifts from “how much suppression do I need to lose weight?” to “how much support do I need to maintain weight and manage hunger?” For most patients, a lower dose provides that support without the intensity of the maximum active dose.
| Context | Approximate dose range | Notes |
|---|---|---|
| Active weight loss (standard protocol) | 0.25mg to 2.4mg escalating | Follows FDA-approved dosing schedule |
| Maintenance after goal weight | 0.5mg to 1.7mg weekly | Most common range; individual variation |
| Lower maintenance and weight stability | 0.25mg to 0.5mg weekly | For patients who maintain well at lower doses |
The shift from active to maintenance is usually gradual. Your provider monitors your weight, side effects, and how you feel at each dose, then adjusts if needed.
Tirzepatide maintenance dose reference
Tirzepatide is a GLP-1/GIP dual receptor agonist. The clinical trials that led to FDA approval used doses ranging from 2.5mg to 15mg weekly, with 15mg showing the greatest weight loss. Like semaglutide, tirzepatide requires dose escalation, but on a faster schedule (4 weeks instead of 16).
Patients who continue tirzepatide after reaching their weight loss goal typically benefit from a lower maintenance dose. The SURMOUNT-4 trial specifically studied what happens when patients move from active treatment to a lower dose or stop completely, and the results inform how providers think about maintenance dosing.
| Context | Approximate dose range | Notes |
|---|---|---|
| Active weight loss (standard protocol) | 2.5mg to 15mg escalating | Per FDA-approved clinical trial escalation |
| Maintenance after goal weight | 2.5mg to 7.5mg weekly | Most common maintenance range |
| Lower maintenance and weight stability | 2.5mg weekly | Starting point for de-escalation |
The SURMOUNT-4 data and what it tells us about maintenance
The SURMOUNT-4 trial[1] followed patients who had completed active tirzepatide treatment and reached their weight loss goals. Researchers then assigned them randomly to three groups: continue tirzepatide at the same dose, continue at a lower maintenance dose, or switch to placebo.
The result was clear. Patients who stopped tirzepatide regained weight. Patients who continued tirzepatide, whether at the higher active dose or a lower maintenance dose, sustained their weight loss. The group on lower maintenance doses did well, which supported the clinical reasoning behind maintenance dosing as a distinct strategy from active treatment.
This trial did not establish an official “microdosing protocol.” But it provided evidence that lower doses, prescribed strategically, can hold weight steady without the intensity needed for active loss.
Why maintenance doses exist
Weight loss medications serve a specific role when your body is fighting to regain weight. The biology that made it hard to lose weight is still present after you reach your goal. Your hunger signals, metabolic rate, and fat storage patterns don’t reset. They remain tilted toward regaining.
Active doses (2.4mg semaglutide, up to 15mg tirzepatide) suppress appetite and slow digestion intensely. That intensity is necessary when you’re fighting to lose 20, 30, or 50 pounds. But once you’ve succeeded, maintaining that intensity creates side effects (nausea, fatigue, loss of appetite for foods you enjoy) without a corresponding benefit. You’re not trying to lose more weight.
A lower maintenance dose provides enough appetite support and metabolic benefit to keep your weight stable while reducing the side burden. For many people, it feels more sustainable long-term.
Additionally, lower doses cost less. They’re easier to tolerate. And they align with the larger goal: build habits and regain control so that eventually you might reduce the dose further or stop it entirely.
How providers think about dose adjustments
Your provider does not guess at maintenance doses. They watch three things:
Weight stability is the primary signal. If your weight drifts up after a few weeks at a given dose, your provider may increase it. If your weight stays flat or drifts down, the dose is working.
Side effects matter next. Nausea, fatigue, and loss of appetite are tolerable during active weight loss when you need maximum suppression. But during maintenance, when the goal is feeling normal and building habits, your provider wants you comfortable. If side effects are significant, the dose might come down.
Your goals and preferences come last, but not least. Some people want the most support the medication can provide. Others want the lowest possible dose. Your provider will adjust within reason to match your preference, as long as weight remains stable.
Transformation Health Microdose program
The Microdose program at Transformation Health is designed for two groups of people.
First, patients who have completed active weight loss treatment. You’ve gone through our semaglutide or tirzepatide program, reached your goal weight, and now want to transition to maintenance. We help you and your provider find the right lower dose to keep weight stable.
Second, people with prior GLP-1 experience and BMI 20 or higher. You may have used GLP-1 medications elsewhere, or you may have been on them in the past. You’re interested in lower-dose support for appetite and weight stability, and you want it at an all-inclusive, affordable price.
The Microdose program costs $199/month. That covers your medication (from a licensed US compounding pharmacy), all provider visits and dose adjustments, required lab work (Quest or Labcorp), and access to our nutrition and fitness coaching team.
Not everyone qualifies. An independent, licensed provider reviews your health history, current medications, and goals. They determine whether the Microdose program is appropriate for you. Some people still need a higher dose. Others may not be candidates for medication at all. The provider assessment is honest about whether the program fits your situation.
How the transition works
If you’re coming from an active weight loss program, the transition to maintenance is gradual and monitored.
Your provider does not simply cut your dose in half. Instead, over a period of 4 to 8 weeks, the dose is reduced incrementally while your weight and side effects are tracked. This helps find the lowest dose that keeps your weight steady without new side effects.
During this transition period, you have frequent check-ins (typically weekly or every two weeks) with your provider. Weight, energy, hunger, and mood are all discussed. Your provider adjusts the dose if needed.
Once your weight stabilizes at a dose you and your provider agree on, the check-in frequency usually decreases to monthly, then as-needed.
Example of maintenance dose experience
Patients on maintenance doses describe a different experience than during active weight loss. Food is still less appealing than it was before treatment. Hunger is quieter. But it’s not the intense suppression of active treatment. You’re not nauseated. You can eat foods you enjoy; you just stop sooner than you did before.
Weight typically stays within a few pounds of your goal. Small fluctuations are normal and expected. Your provider helps you understand what normal variation looks like for you.
Most people report that maintenance dosing feels sustainable. It’s lower cost, fewer side effects, and a more balanced relationship with food and appetite than active treatment required.
Important disclaimer
The dose ranges shown on this page are reference information only. There are no FDA-approved “microdosing protocols.” Maintenance dosing after weight loss is an emerging clinical practice that providers use within appropriate medical judgment.
All doses for compounded medications require evaluation by an independent, licensed healthcare provider. Your provider reviews your health history, current weight, labs, and any medications you’re taking, then determines the dose that is appropriate for you.
You should not adjust your dose on your own, even if these tables make a different dose look like it might work better. Dose adjustments always require provider guidance and follow-up monitoring. What looks like a small change can have meaningful effects on your weight, appetite, and metabolism.
Citations
[1] Aronne LJ, et al. “Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial.” JAMA. 2024;331(1):38-48. https://pubmed.ncbi.nlm.nih.gov/38078870/
Important: Compounded medications are not FDA-approved products. They are prepared by US-based, state-licensed compounding pharmacies and have not been independently evaluated by the FDA for safety, efficacy, or quality. The dose ranges on this page are reference information only. All dose decisions require evaluation by an independent, licensed healthcare provider. Not all patients will qualify. Results vary by individual.