Morning all
I asked chatGPT if there was any research on long term maintenance at 2mg, and whether I should continue to taper down. This is the summary in case it’s interesting for anyone here:
The key facts that matter for you
• You’re now BMI 21–22 (healthy range)
• You’ve maintained 58–59 kg since Aug
• You’re stable even after dropping below studied doses (2 mg)
• You’re not actively trying to lose more weight
• The dose is clearly acting as maintenance, not appetite suppression
That puts you outside the population most tirzepatide research is based on — which is important.
What we know
- In SURMOUNT, stopping GLP-1/GIP therapy entirely led to partial weight regain in most people
- Lower doses = fewer side effects, but still provide satiety signalling
- Long-term obesity is increasingly understood as a chronic condition, not a short-term treatment issue
What we don’t know
- There is no trial data on:
- BMI-normal individuals
- Maintenance below 2.5 mg
- Ultra-low dosing like 1.25 mg
- There is no evidence-based “ideal” exit strategy
So we’re in clinical judgement territory, not protocol territory.
Three realistic options — and who each suits
🟢 Option 1:
Stay at 2 mg weekly (most conservative)
Best if:
- You value stability over experimentation
- You feel mentally calmer knowing there’s a “buffer”
- You have no side effects
Pros
- You already know this works
- Lowest risk of rebound hunger
- Likely minimal metabolic impact at this dose
Cons
- You may be taking slightly more than needed
- Psychological dependence can creep in (“what if I stop?”)
👉 This is the safest default if nothing feels urgent.
🟡 Option 2:
Trial 1.25 mg weekly for 6–8 weeks (my personal favourite for you)
Best if:
- You want to see how little support your body actually needs
- You’re comfortable monitoring weight trends calmly
- You want an off-ramp without jumping straight off
Pros
- Tests whether your set-point is holding
- Still provides some GLP-1 signalling
- Makes eventual stopping easier if you choose to
Cons
- You may notice subtle hunger return (not weight gain — hunger)
- Requires emotional neutrality about the scale
👉 If weight stays within ±1 kg over 6–8 weeks, that’s a strong green light.
🔵 Option 3:
Stop altogether
Best if:
- You’re okay with the possibility of some regain
- You feel confident in your eating patterns
- You’re willing to restart quickly if needed
Pros
- No medication dependency
- Clean physiological baseline
Cons
- Highest risk of rebound appetite
- Regain, if it happens, is usually fast, not gradual
- Restarting later can feel psychologically harder
👉 Most people who stop successfully do so after a long taper, not from 2 mg.
What I’d suggest if you were my patient
Not medical advice — but informed, pragmatic guidance:
➡️ Step down to 1.25 mg weekly for 6–8 weeks
- Weigh once weekly only
- Ignore day-to-day appetite noise
- Watch for:
- sustained hunger
- food obsession
- weight trend > +1.5 kg
If stable:
→ either stay at 1.25 mg or trial stopping
If weight creeps up:
→ go back to 2 mg without guilt — that’s still a very low maintenance dose
One important reassurance
Staying on a very low maintenance dose at a healthy BMI is not a failure, and it’s increasingly how obesity specialists think about long-term care — similar to blood pressure or cholesterol meds.
You’re not “cheating.”
You’re choosing metabolic insurance.
I asked about long term risks of staying on 2mg and it couldn’t come up with any physical ones, as all the risks are connected to fast weight loss. It did say I could find myself psychologically dependant on it - with increased anxiety around not being able to take it. And for that reason it might be worth experimenting with tapering down/coming off:
Psychological / behavioural dependence
This is the most realistic long-term issue — and it’s subtle.
Signs to watch for:
- Anxiety about missing a dose despite stable eating
- Fear of hunger rather than actual hunger
- Feeling unable to trust your body without medication
Your planned taper is exactly how you prevent this.
I do read about all the amazing benefits they’re discovering with this drug, just wish there was more research out there on low doses.