What changes once you reach maintenance

During active weight loss, reviews track your progress towards an agreed reduction. In maintenance, the focus moves to keeping you healthy, avoiding unwanted further loss and protecting nutrition and strength. A stable weight is often the intended result. Treatment has not failed.

Adult weight-management eligibility in the licence uses your starting BMI. A lower BMI reached on treatment does not wipe out that history. Keep reliable records of your starting measurements and prescriptions, especially if you change provider.

Licensed maintenance doses

The recommended adult maintenance strengths are 5, 10 and 15 mg weekly. No rule says everyone should take the highest dose, or drop to one set dose after reaching a target. Your clinician should explain the chosen dose in terms of your response and how well you tolerate treatment.

Longer gaps between doses, counting clicks and cycling on and off treatment have no evidence as equivalents to the licensed regimen. If a prescriber suggests another approach, ask for the reasoning, the evidence, the monitoring plan and whether the approach falls outside the authorised schedule.

What SURMOUNT-4 showed about continuing

SURMOUNT-4 studied adults without diabetes. All started on tirzepatide and were then assigned either to continue or to switch to placebo. The placebo group regained substantial weight on average. The group who continued kept their weight off and lost more. The results support treating obesity as a condition needing long-term management for many people.

The trial does not prove everyone needs lifelong treatment at a set dose. It studied a selected group on a specific regimen. How long you stay on treatment depends on your preferences, cost, side effects and the other support available to you.

What to monitor besides weight

A maintenance review should cover appetite, nutrition, strength, physical activity, mood and the burden of treatment. Blood pressure and glucose medicines may need reassessing as your health changes. If you keep losing weight below the agreed range, get a review. Do not assume further loss is good news.

An agreed weight range works better than one exact number. Normal shifts in fluid and bowel habit move the scale without any loss of control. Agree in advance which upward or downward trend should prompt contact, and what extra support you would get.

Plan for continuity and for stopping

Ask how long the service expects to provide maintenance care, what reviews cost and what happens if you change provider. A clinic's policy applies to that clinic and sets no clinical rule. NHS funding and local service limits also sit apart from the licensed indication.

If stopping becomes right for you, or unavoidable, agree follow-up and a plan for returning hunger, weight change or glucose changes. Maintenance is no test of willpower. A good plan makes later decisions easier and allows for your needs to change through illness, pregnancy planning or changes in what you can afford.

Sources

Your own medicine leaflet and prescriber come first. A source from another country does not mean the same rule applies in the UK.

  1. Mounjaro UK Summary of Product Characteristics, updated September 2026 medicines.org.uk
  2. NICE: prescribing, reviewing and stopping tirzepatide nice.org.uk
  3. SURMOUNT-4: continued tirzepatide for maintenance of weight reduction pmc.ncbi.nlm.nih.gov
  4. NICE TA1026: recommendations nice.org.uk

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