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 is a different job than active weight loss. During active treatment, the dose is stepped up until it is doing enough to reduce weight. During maintenance, the goal is stability, manageable side effects, and long-term management, and some providers look for the lowest dose that holds weight steady.

The tables below show illustrative ranges providers may use when moving to maintenance dosing. They are not a protocol, and they are not Transformation Health’s recommendation. Where a range sits below the labeled maintenance doses, it is off-label, meaning a provider is using clinical judgment outside what the FDA reviewed, and there is little trial evidence for it. A provider may choose a dose inside or outside these ranges based on your response and health history. These are not prescriptions or recommendations. A licensed provider decides your dose.

Semaglutide maintenance dose reference

Semaglutide is a GLP-1 receptor agonist. Brand-name semaglutide for weight management (Wegovy) starts at 0.25mg weekly and steps up every 4 weeks over 16 weeks. The label’s maintenance dose is 2.4mg weekly (recommended) or 1.7mg, and the current label allows people who have tolerated 2.4mg for at least 4 weeks, and need additional weight reduction, to increase to a maximum of 7.2mg.^[3]

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?” Some people and their providers try a lower dose for that support, though the evidence for doses below the label is limited.

The shift from active to maintenance is usually gradual. A 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. Brand-name tirzepatide for weight management (Zepbound) starts at 2.5mg weekly for 4 weeks, then rises in 2.5mg steps, at least 4 weeks apart, to a maximum of 15mg. The 2.5mg dose is for starting only; the labeled maintenance doses are 5mg, 10mg, or 15mg.^[2] That means the lowest maintenance dose can be reached after 4 weeks, while reaching 15mg takes at least 20 weeks.

Some people who continue tirzepatide after reaching their weight loss goal move to a lower dose, and some providers use doses below the labeled maintenance range. The SURMOUNT-4 trial studied what happens when people continue tirzepatide or stop it, and its results inform how providers think about maintenance.

The SURMOUNT-4 data and what it tells us about maintenance

In the SURMOUNT-4 trial,^[1] published in JAMA in 2024, adults took tirzepatide at their maximum tolerated dose (10 or 15mg) for 36 weeks and lost an average of 20.9% of their body weight. They were then randomly assigned to two groups: continue tirzepatide at the same dose, or switch to placebo.

Over the next 52 weeks, weight in the placebo group rose by an average of 14.0%, while those who stayed on tirzepatide lost a further 5.5% on average. The people who kept their results stayed on 10 or 15mg. The trial did not test stepping down to a lower maintenance dose. Results vary, and trial results describe study participants, not a prediction for any individual.

This trial did not establish an official “microdosing protocol.” It supports continuing treatment, not any particular lower dose. Whether a lower dose can hold weight steady for you is an open clinical question and a decision for you and your provider.

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.

Higher doses (2.4mg semaglutide, up to 15mg tirzepatide) suppress appetite and slow digestion more strongly. That level of support is what many people use while losing weight. Once you reach your goal, some people find the side effects (nausea, fatigue, loss of appetite for foods you enjoy) harder to accept when they are no longer trying to lose more weight.

A lower maintenance dose aims to provide enough appetite support to keep your weight stable while reducing the side effect burden. Some people find it more sustainable long-term, though the evidence for doses below the label is limited.

A lower dose may also cost less, depending on how the product is priced; some products cost the same at every dose. Some people also hope to reduce the dose further or stop over time. In SURMOUNT-4, people switched to placebo regained weight on average, so that is a decision to make carefully with a provider.

How providers think about dose adjustments

A 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, a 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 may feel tolerable during active weight loss. But during maintenance, when the goal is feeling normal and building habits, a 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. A provider may adjust within reason to match your preference, as long as weight remains stable.

What to check before using a lower maintenance dose

If you are thinking about a lower maintenance dose, these questions help you compare programs and understand what a provider would actually do. Ask them of any program you are considering.

1. Dose and label. What maintenance dose would you suggest for me, and is it within the labeled maintenance doses or below them (off-label)? What evidence supports it?
2. Step-down plan. How would you lower my dose, how quickly, and what would make you raise it again if my weight starts to climb?
3. Brand-name or compounded. Would my prescription be an FDA-approved brand-name product or a compounded one? If compounded, which licensed pharmacy fills it, and is it a 503A or 503B pharmacy?
4. Total cost. What is the full monthly cost at my dose, does it change when my dose changes, and what does it include (medication, visits, labs, shipping, membership fees, cancellation terms)?
5. Monitoring. Who checks in on me, how often, and what lab work is involved?
6. Who prescribes. Is the prescriber a physician, nurse practitioner, or physician assistant, and are they licensed in my state?

At most telehealth programs, a licensed provider reviews your health history, current medications, and goals, and decides whether a prescription is appropriate, and at what dose. Some people still need a higher dose. Others may not be candidates for medication at all. Transformation Health does not accept payment from providers. How we make money.

How the transition works

If you’re coming from active treatment, the transition to maintenance is usually gradual and monitored.

Many providers do not simply cut the dose in half. Instead, the dose is often reduced in steps while your weight and side effects are tracked. There is no labeled step-down schedule, and approaches vary by provider. The aim is to find the lowest dose that keeps your weight steady without new side effects.

During this period, some programs schedule more frequent check-ins with a provider. Weight, energy, hunger, and mood are all discussed, and the provider adjusts the dose if needed.

Once your weight stabilizes at a dose you and your provider agree on, check-ins often become less frequent.

Example of maintenance dose experience

Some people 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. Nausea may ease. You can eat foods you enjoy; you just stop sooner than you did before.

The goal is for weight to stay within a few pounds of where you landed. Small fluctuations are normal. A provider can help you understand what normal variation looks like for you. Results vary, and some people regain weight at lower doses.

Some people say maintenance dosing feels more sustainable, with fewer side effects and a more balanced relationship with food and appetite than active treatment required. Others find a lower dose is not enough.

Important disclaimer

The dose ranges shown on this page are illustrative reference information only. There are no FDA-approved “microdosing protocols.” Ongoing doses below the labeled maintenance doses are off-label, and maintenance dosing after weight loss is an emerging clinical practice that providers use within their medical judgment.

All doses, including doses of compounded medications, require evaluation by a licensed provider. A provider reviews your health history, current weight, labs, and any medications you’re taking, then decides the dose that is appropriate for you. Compounded medications are not FDA-approved. The FDA does not review them for safety, effectiveness, or quality, and they are not the same as brand-name products.^[4]

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.

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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/

[2] Eli Lilly and Company. ZEPBOUND (tirzepatide) injection, prescribing information, sections 2.1 and 2.2. Revised 08/2026 (NDA 217806, supplement 41). Accessed 2026-10-16. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/217806Orig1s041correctedlbl.pdf

[3] Novo Nordisk. WEGOVY (semaglutide) injection, prescribing information, section 2. Revised 06/2026 (NDA 215256, supplement 25). Accessed 2026-10-16. https://www.accessdata.fda.gov/drugsatfda_docs/label/2026/215256s025lbl.pdf

[4] U.S. Food and Drug Administration. “FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss.” Accessed 2026-10-16. https://www.fda.gov/drugs/drug-alerts-and-statements/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss