How do I start a maintenance routine?

[JustPickleRick]

I've pretty much reached my goal weight - Gone from 12 st 9 down to 8 st 9.

I did:
10 weeks on 2.5mg
13 weeks on 3.75mg
I'm currently on 4.17mg which i've been on for the last 7 weeks.

I've been ordering my pens from Asda as it was easier.

I'm really unsure of how to approach the next part of my journey though. I see two different routes seem to be the most common. Moving back down to a lower dose and injecting weekly OR lengthening the time between doses.

I think I'd like to extend the time between doses but I don't think asda would allow that? I imagine it will get to a point when they see I am not re-ordering on time.

Any advice on next steps please and how best to approach it.

Also, which providers are good for supporting maintenance with longer times between?

I've tapered down from 15mg in September at bmi 25 and currently doing 5mg at bmi 22. The only issue with leaving long gaps is you could get more side effects as the dose concentration drops quite low before dosing again so it's highs and lows to the body. So quite a few people taper down to a lower dose like 2.5mg or 1.25mg and then increase the gap to 10 days and then 14 days.
If you are going to increase your gap, you would still have to order every 4-6 weeks or whatever your provider asks for to stay on the books especially at a lower bmi and if you are not with a maintenance friendly pharmacy. I'm with oushk on a maintenance plan so they allow 6 weeks between orders and if I had a gap I would just have to go back to 2.5mg.
If I wasn't with oushk I'd definitely move to Pharmulous who also allow you to have a gap and reorder within 12 months. It's always more cost effective to order a higher dose and take the smaller doses. At the moment I'm doing 5mg from a 10mg pen bought in August and it's costing me £14 a week!

Thanks for your reply. How do you taper down? Jump down to the next pen dose each week or through microdosing less and less each week?

It is trial and error really. I tried to be patient with each step to get a good idea what was happening.

I started by staying on same dose, increasing calories to approx maintenance level and monitored weight over a few weeks. I never tracked calories, essentially ate the same high protein, fibre as before and introduced some extra carbs such as would have a wrap with my chicken salad, or extra sweet potato fries, or a small slice of bread to dook in my soup, I started drinking kefir with poppy seeds mixed in, some walnuts daily etc.

Trend was still slightly downward over a few weeks, so tried to introduce more calories here and there healthily.

Then I tried dropping from my highest does 3.75mg to 3mg. Gave it several weeks. Monitoring weight. Never noticed much of a change in food noise etc.

Now just dropped to 2.5mg a couple of weeks ago as works out better for partial doses and will monitor there for a couple of months.

It may be overly cautious or slow, but I want to do it deliberately and avoid going back up for a couple of reasons. Firstly want to avoid having to talk to GP about increasing potentially impacting oral HRT (I have just increased HRT dose too so don’t want to rock that boat). I also want to be cautious about pre Mounjaro issues (swollen ankles, joint pain that disappeared very quickly when I first started) possibly returning.

Picture is how it is going so far, blue dotted line target weight.

I only stayed on 15mg for 1 pen because it was far too strong, could only eat 700-900 cals, and i felt like a zombie, really low and just laying on sofa all time, then i did 12.5mg for 2 weeks for same reason, then did 10mg for a month until that got too strong and then did 8.75mg and 8mg then 7.5mg for a month. Then wegovy for 3 months 1.7mg and back to 7.5mg for a month now at 5mg. I listen to my body and if it feels too strong drop a whole dose, if its slightly too strong then inbetween. Longer tapering down has better results for avoiding weight gain than cold turkey or sharp drops of dosage. If 5mg is too strong, I'll probably do 3.75mg before 2.5mg.

I’m maintaining 8:0 at 5ft 4. I take 5mg every seven days.

I did try spreading the dose over a longer period but I found I had bad side effects from doing that.

I may try jumping back down to 3.75 on my next jab and see how i get on. I took that accidentally a week or 2 ago and my week was pretty much the same. I'd like yo grt down for the summer as I have a holiday and i'm worried about being on the jab whilst away as I want to be able to enjoy myself!

Asda are quite a pricey supplier so have a look on www.monj.co.uk and look for a maintenance pharmacy

I went down from 5mg every seven days to 2.5mg every five days. I think my next step will be to increase the gap at 2.5mg to weekly and then taper down again. I had decided to do that anyway but then ran it all by ChatGPT to help me with a maintenance plan. I obviously wouldn’t take medical advice from it but it was helpful to have some strategies for what to do as the suppression reduced.

Thanks everyone. I used Google Gemini to come up with a plan and it was so helpful! Gave me clicks to do over so many weeks to get back down to 2.5mg. I've officially hit my 4 stone loss today so I think i'll go for 2 more lbs and that's it

Ahhh well done @JustPickleRickI joined the maintenance thread on here last month and have had brilliant advice from there. I chose to increase my calories gradually first (from 1000 to 1400 currently) Once they are at 1500 per day and my weight stabilises (still currently losing every week) I will then start reducing the dose, stabilise my weight and then increase my calories again to 1700, stabilise my weight and then reduce further or extend days between dose.

Ahh nice to see you here 🤩 thank you! I couldn't see a thread on the main weightless section, i'll have another look. I need to get back into a solid routine with my food so I can think a out increasing. How are you finding it so far?

The thread has a long Christmas title called ‘oh come all ye injectors, losers and maintainers’ it’s def worth following.

I’m doing good, once I managed to convince my head that it was definitely time to increase calories it’s been better. Having routine with eating and exercising is definitely a big advantage. My non negotiable’s are Collagen in coffee every morning, ‘my protein’ clear whey protein drink at lunchtime and a Aldi protein mousse or yoghurt after dinner. That always gives me 54g of protein without thinking about it which makes planning the rest of my food easier.

I have the Nutrition Geeks collagen each morning in a hot choccie, nice little treat! I think i will invest in a protein shake to boost my numbers through the day, usually hit around 80-90g a day but know that could be better! Once i'm back off half term, i'll get back into it properly 😅 I've been eating more calories lately but still finding myself shrinking 🫠

That’s the one I use as well. I find nutrition geeks stuff really good I’ve ended up using their magnesium, biotin, turmeric and omega supplements as well. It’s definitely worth trying to get a protein drink in if you can. 😆 that’s not a bad thing eh!

I'm not on maintenance yet but it seems some people are spacing out their jabs. Instead of doing it every 7 days, they stretch it to 10, 12, 14 days. It's mostly about making the prescription go a bit further and keeping the costs down, while still trying to find that sweet spot where the appetite stays in check.

I had to stretch my jab this week as I was away on jab day. Ended up going from friday to monday, 10 days. I've really struggled this week after having the jab on monday! I've got a horrible headache and can't eat much. I have no idea if its linked to going longer but its really put me off! This friday i'm going to go back down to 3.75 from 4.17. Already apprehensive sive though as its only a few days since I last jabbed! I prefer a friday though as it gives me the weekend to deal with side effects if I ever get any.