Finding the right weight loss medication maintenance dose for you

What is a maintenance dose? 

When you start a weight loss treatment, you’ll typically start on a low dose while your body gets used to the treatment. This will be decided in consultation with your clinician based on your individual circumstances. You’ll take this for around four weeks while your body gets used to the treatment. Your clinician may then decide to gradually increase the dose depending on your progress and how well you’ve tolerated the treatment or if you’ve experienced any side effects.

A maintenance phase is the stage after you and your clinician have reviewed your progress and agreed the next clinically appropriate step. This may involve continuing your current dose, adjusting your treatment, pausing treatment, stopping treatment, or considering another suitable option. The dose your clinician may recommend you remain on while continuing treatment during this phase will be your maintenance dose.

There is no ‘one size fits all’ approach with this and it’s important to know that you will not always move up to the highest dose possible, because you will start on the lowest dose and then move on to the correct clinically approved dose for you over time.

What happens when I reach my goal weight?

Reaching your goal weight is an important milestone, but it’s not the end of your weight management journey. Maintenance matters, and what happens from this point on will depend on what’s clinically appropriate for you. For some patients, continuing treatment may help support weight maintenance and reduce the risk of weight regain, where clinically appropriate. Your treatment plan should be reviewed with a clinician once you reach your target weight. 

Alongside any ongoing treatment, maintaining healthy lifestyle habits remains essential. This includes getting enough protein, incorporating resistance training, prioritising good sleep, staying active, and managing stress. Lifestyle habits can support weight maintenance, but they do not replace clinical review and do not guarantee that treatment can be reduced or stopped. 

When should I move on to a maintenance dose? 

Throughout the course of your treatment, you will be able to submit a consultation form online to check in on your progress or review any issues with a clinician, and to determine your next steps. 

They will review your individual treatment plan and consider your full medical history. They will also review your progress against your target BMI range. Once you’ve reached your target range, you will enter what’s known as a ‘maintenance phase’. 

This is the point in your weight loss journey where your clinician may recommend a dose or treatment plan that helps support weight maintenance and reduce the risk of weight regain for some patients, where clinically appropriate. This should be combined with positive lifestyle changes, regular clinical reviews and, where relevant, review of any diabetes-related factors or blood glucose monitoring. 

What is the lowest effective dose?

The lowest effective dose, sometimes called the minimum effective dose or MED, is the amount of treatment needed to achieve a therapeutic effect. This can look different for everyone, as individual responses to GLP-1 treatment vary. Once you’ve reached your goal weight, the focus typically shifts from losing more weight to finding a dose that helps you feel satisfied, keeps your weight stable, and fits comfortably into your day-to-day life. 

Determining the right maintenance dose should always be done through a clinical review. Your clinician will review whether your current treatment and dose remain appropriate. Any change will depend on your response to treatment, side effects, current health, and applicable clinical guidance. 

How do I know my target BMI range?

Your clinician will request your current BMI to ensure you are suitable for the treatment you’ve requested. You can calculate your BMI here. They will also calculate your ‘target BMI range’ – this will be the target range for you to get to while on your weight loss treatment based on your medical history, age, and ethnicity.  

However, there is a healthy range defined by the NHS as a BMI between 18.5 and 24.9. It is important to note that the BMI ranges are slightly different for people from Asian, Black African, African-Caribbean or Middle Eastern backgrounds, who may have a higher chance of health problems at a lower BMI.  

BMI is one measure used to assess suitability, but it is not a complete assessment of health. Your clinician will consider your BMI alongside other relevant clinical information. 

What should my maintenance dose be? 

This will be completely individual to you. The clinician will consider your treatment plan, your medical history, your individual details including current and target BMI, and your own feedback on your experience so far, before making their recommendations. Do not change your dose yourself. If your weight changes, side effects develop, or your treatment no longer feels suitable, mention this during your next consultation or submit a consultation form. A clinician will review your information and decide whether any change is clinically appropriate. A dose increase may not be suitable or guaranteed.

Can my treatment plan change during maintenance?

If you are having problems with your current treatment or want to discuss alternatives, contact your clinician. They will review whether any change is clinically appropriate for you. Switching to tablets may suit some people, but not others. 

You can find more information about switching weight management treatment here.

If I am on a low maintenance dose, can I increase it later? 

Do not change your dose yourself. If your weight changes, side effects develop, or your treatment no longer feels suitable, mention this during your next consultation or submit a consultation form. A clinician will review your information and decide whether any change is clinically appropriate. A dose increase may not be suitable or guaranteed. 

How long should I take a maintenance dose for?

You can take the maintenance dose agreed with your clinician for as long as it remains clinically appropriate. Your treatment will be reviewed through the Pharmacy2U consultation process at appropriate points, based on your treatment plan and clinical needs. 

If you experience an increase in weight, you should include this on your next consultation with a clinician for your repeat treatment so that they can review your dose. If you feel like you want to come off the maintenance dose after a period of time, you can plan in consultation with your clinician to stop when you feel ready to try and maintain your new weight with lifestyle management (diet and exercise).  

If you want to restart treatment in future, you would need to complete a new consultation. A clinician will decide whether treatment is safe and appropriate based on your current health, BMI, medical history and applicable prescribing guidance.

How can I manage side effects during maintenance? 

There are a range of common side effects that can occur as part of your weight loss treatment journey. Side effects are often gastrointestinal and usually non-serious but can sometimes lead to complications such as severe dehydration. It is still important to mention these to your clinician or provider if you experience them. 

If you notice a change in how side effects are impacting you while you are on your maintenance dose, you should mention this to your clinician during your next consultation to continue treatment so they can review your dose. Although rare, if you experience any of the more serious side effects, stop taking the treatment immediately and seek medical advice as soon as you can by contacting your prescribing clinician or calling NHS 111.  

We encourage all patients who experience side effects of any medicine they take to report these via the Yellow Card Scheme, either through the website or by downloading the app. 

How can I monitor my progress on my maintenance dose? 

For your weight loss journey to be successful, it’s key to keep track of your progress. That doesn’t just mean tracking your weight, but can also include keeping a note of your dietary habits, physical activity routine, and your overall health. 

It can help to keep a journal or use digital tools to note down your eating history, your exercise routine, any health concerns or side effects you’ve experienced, and any other details you can feed back to your clinician. This is helpful so they have as much information as possible to make any necessary changes or adjustments as needed. It can also help develop your awareness of positive routines around food intake and exercise to support your weight management journey after treatment.

How do I come off a weight loss treatment?

There are several ways to come off GLP-1 weight loss medication, and the best approach will depend on what’s clinically suitable for you. Options may include reducing to a lower dose, gradually tapering down over time, switching to an alternative form such as tablets, or stopping treatment with appropriate support in place. These decisions should always be made in discussion with your clinician, who can guide you based on your health, weight history, and overall progress. 

It’s important not to make changes to your dose or stop treatment suddenly without medical advice. A planned, gradual approach may help your body adjust, as some people experience an increase in appetite, cravings, or intrusive thoughts about food, sometimes described as “food noise”, after suddenly stopping GLP-1 treatment, and weight regain is common. Your clinician can help you navigate this transition safely to maintain the lifestyle habits that will support long-term weight management. 

What supports long-term weight management success?

Long-term success with weight management is typically supported by a combination of treatment, lifestyle changes, sustainable habits, and ongoing clinical support. While GLP-1 treatment can play a helpful role for some people, it isn’t required indefinitely for everyone. What matters most is a personalised, clinically appropriate plan that evolves over time. Ongoing care, including regular check-ins and monitoring, helps ensure that your approach continues to meet your needs as your body, health, and circumstances change.  

Alongside any medical treatment, consistent lifestyle habits are key. This includes balanced nutrition, regular movement, good sleep, and addressing psychological or behavioural factors that may influence eating patterns. A supportive environment, whether through healthcare professionals, family, or peer support, can also make a meaningful difference in maintaining progress. Tell your clinician promptly if you are pregnant, planning pregnancy, breastfeeding, or if your contraception changes. Do not stop or change treatment without medical advice unless you have been told to do so by a healthcare professional.

How can I contact my clinician if I have a question or a problem?

If you have any questions about your maintenance dose or switching treatment, you can contact your clinician by logging in and sending them a message from your Account Dashboard. 

When to seek urgent help

For routine questions about your treatment plan, contact your clinician through your Account Dashboard. For severe, persistent or rapidly worsening symptoms, seek urgent medical help using NHS 111, 999 or A&E depending on the urgency. 

Seek urgent medical attention if you develop severe and persistent abdominal pain, which may radiate to your back and may be accompanied by nausea or vomiting. You should also seek urgent medical advice if you develop sudden changes in vision, sudden loss of vision, or rapidly worsening eyesight.