if you find maintenance harder than the losing part you are in the majority in this room
#maintenance 2025-06-08
- no_appetite_nia — how much protein were people eating at maintenance compared to while losing 17:09
- void_volume — there is a trial that tells you what happens if you take it away entirely, which is a different question but the most useful one we have 19:04
- two_labs_two_answers — the four hedges in that sentence are all doing work 19:12
- void_volume — correct, and thats the honest limit of it 19:34
- still_here_2024 — if you read one line out of this channel today read that one 20:48
regain after stopping is the expected outcome, which is a horrible sentence and also what the data says
the honest answer to is this forever is that nobody knows and the drug only works while you are taking it
i lift twice a week specifically because losing fast without it cost me more than i was willing to lose, still working it out
coming down too fast was my mistake. top rung to the bottom rung inside a month and it was a bad month
m0 118.4
m1 113.9
m2 110.2
m3 108.8
m4 108.1 <- the stall
m5 105.0
m6 101.6
m7 99.2thats fluctuation
how much protein were people eating at maintenance compared to while losing
m0 118.4
m1 113.9
m2 110.2
m3 108.8
m4 108.1 <- the stall
m5 105.0
m6 101.6
m7 99.2come down slower than that
i weigh weekly at maintenance rather than daily and my range is about two kilos either side
harder than losing
did your maintenance dose end up higher or lower than you expected it to
anyone gone off entirely and stayed off successfully
thats STEP 4
appetite returning is not the drug failing, it is the drug doing less because you are taking less of it
i dropped from 15 to 5 for maintenance and held steady for fourteen months
mine didnt hold
is this forever or is that just how it feels at month 4
follow up appetite came back over about three weeks after i reduced, not all at once, which is what i had braced for
[edited]update from 19 months ago: still at maintenance, still boring, which was always the goal, i could be wrong
hit my goal in may. nobody told me what happens next and im slightly adrift
welcome to the least discussed half of all of this
the whole internet is about getting there. almost nothing about staying
so do i come down off the dose or stay where i am
thats the actual open question and you will get two honest camps in here within about four minutes
camp one. i dropped to half my treatment dose and held weight for 14 months. cheaper, fewer side effects
camp two. i tried dropping and my appetite came back inside three weeks so i went straight back up and stayed
and there is no trial that tells you which
there is a trial that tells you what happens if you take it away entirely, which is a different question but the most useful one we have
everyone titrated to 2.4 for 20 weeks first, then two thirds carried on and one third switched to placebo
the continuers lost roughly another 8% over the next 48 weeks. the withdrawn group gained roughly 7% back
so it reverses
in that trial, on average, over that window, yes
the four hedges in that sentence are all doing work
they are. but the direction has been replicated. the off-treatment extension of STEP 1 pointed the same way, most of the loss returned over about a year
which is why the forever argument is not really an argument about willpower
it also isnt proof that YOU specifically regain. it is proof that groups do
correct, and thats the honest limit of it
i know two people who stopped and held. i know eleven who stopped and didnt
small sample, obviously, and the two who held both went hard on lifting
so does STEP 4 mean i should never stop
STEP 4 doesnt say what you should do. it says what the drug is doing while you take it, which is holding a physiology in place, not resetting it
if you take away the thing holding it, the thing goes back. thats not a moral failing, its a pharmacology result
if you read one line out of this channel today read that one
pinning that for #maintenance
my clinic wants to taper me off over 3 months and i dont know how to feel
thats a conversation to have with them, with STEP 4 in your hand as a question not as an argument
ask them what the plan is if weight comes back. if they have an answer, fine. if the plan is disappointment, thats not a plan
brutal and im writing it down
and to your original question, up or down — there is no trial comparing maintenance doses head to head. anyone who tells you otherwise is guessing confidently
we disagree on this and we are going to keep disagreeing, which is fine
very fine. i just dont want the newcomer to think theres a settled answer
message received. no settled answer, one good trial, two camps