Why I Chose to Lower My Dose Indefinitely — and My Doctor Doesn't Agree.
My Doctor Said "If You Stop Taking glp1s, you will be back where you were within a year. You Will Need to Continue to Take These Meds to Receive the Benefits".
How I Started My Journey on glp1
I met with my cardiologist, did some tests for him and saw him in person. He spoke to me about my overall health picture and the fact that I needed to lose weight to round out my health journey. I had been exercising regularly for over 3 years in the pool doing aquafit and swimming. The overall improvement in how I could move and eliminated pain drove me back every few days. I added a weekly gym session with a trainer for the previous 6 months consistently.
After a conversation about metabolics, my weight, my wish to avoid family cardiac issues and avoid knee replacement. He told me he wanted me to take glp1 meds and explained how glp1 meds work. It was my decision what med I took. I was not pre-diabetic or diabetic so this script for a glp1 is off-label and therefore not covered by insurance. I had a script in April but didn’t fill it and start until August. I had to get myself mentally ready for this experiment I was joining. I didn’t want to miss out on something that could make a difference for me. But I wasted months with this and then the cost is out of pocket and I had to be prepared to start and keep taking it. I would need to afford it indefinitely. Wow. I started in August same year but that was months of waiting for no reason.
My cardiologist’s nurse reached out to me with the script and info about how I am to start with lowest dosage and progress to next dosage every 4 weeks. I faithfully followed the plan increasing dosage and eating small meals. So, fast forward to now and I’ve taken glp1 Zepbound since August 2025 non-stop. It immediately ended my sweet tooth and curbed my hunger. Most of my weight issues were around carbs - a crazy sweet tooth that did me no favors with the dentist. My appetite changed and what I liked to eat changed a bit as well. I don’t eat the same way anymore. I had to learn to focus on getting enough protein and water each day, much less enough calories.
I lost 60 pounds and wanted to start slowing things down a bit. I’d lost 2 or more pounds a week for a long time. There were a few weeks that I didn’t have downward movement but I didn’t gain weight back. I am now at high school weight, feeling and moving better than I have in years. I have followed the plan and am on highest dosage and no plan to change that. I think the highest dosage is too high for me. I have to work very hard not to be sick the day after the shot. It slows digestion down so much that food is still in my stomach after 24 hours. I’ve had to eat very little, bland food, drink tons of water and stop eating early in the day of the shot. Or the next morning anything in my stomach just comes back up.
“So what’s the long term plan for me, and what dosage should I expect to stay at?”
I tried to get answers about long term usage and dosage but was unable to get anything definitive. I was concerned that I didn’t need such a high dosage after losing so much weight and nearing my personal goal weight. My size in clothes is approaching what I am looking for. I still need to tone my muscles and get stronger. My skin is loose in some spots and partner says my face is getting thin. All stuff that will happen with great weight loss and not something a lot of people go thru until now. Now, there’s a lot of us that are doing something to improve our lives and our bodies. But it’s different when you lose weight and you are older. It’s harder when you’re older and your skin is older too so it doesn’t snap back after weight loss. I’ve been told it will get better as I spend a longer time at a smaller size. Face shape and hanging skin or loose skin is an issue and for some it won’t change much and for others it will snap back over time and not be an issue. It’s hard to see even though I expected it. I speak from experience here too. I had lost 80 pounds in my early 40’s after reducing calorie intake and working out like crazy for 6 months. I had some skin looseness but had the body chemistry to deal with it. Speed up 20 years and my body is different but the feeling is the same — success paired with new clothes and ease in movement. A win win. But I didn’t know what to do to maintain and not gain.
Well funny thing, maintenance or staying around a certain weight is still an issue when you use a glp1 med. I was unable to get an answer from my cardiologist or from manufacturer’s pharmacist about long term dosage for myself. In fact, both said to stay on the highest dosage. I finally took myself off that dosage on my own. I think we don’t have the facts and knowledge about how to use this med long-term. It seems at a lower weight, maybe lower dosage needed. The doctor and pharmacist are under the impression that there’s some sort of tolerance at lower dosages that is developed and it wouldn’t work to lower dosage. I don’t think that is true. There are people that are micro dosing glp1 meds and never go with full dosages. Their results may be different and side label benefits will be different without full dosage.
Studies do show that earlier users of the glp1 meds stopped taking them after reaching their goal weight. Many of them gained the weight back after stopping or gained a good percentage back. So, how many people change eating habits during and after use of glp1 meds? Are the meds needed to maintain a great deal of weight lost or will a person be able to go it alone after? That is the real question and it may be a different answer for some of us. Some can stop taking the glp1 meds and control diet and maintain. But who can’t and when do cravings and “sweet tooth” for me, when would that come back? Does it?
The Plan to “Never Get Off” It
After I hit my goal weight, I had a plan. I’d taper down slowly, let the medication phase out, and transition into pure habit-based maintenance. The medication had done its job. I had done the work. Now I’d prove it by not needing it anymore. But that wasn’t my doctor’s plan. His plan is that I keep taking it indefinitely. My hope is that the glp1 meds start being covered in insurance plans for anyone that fits some identified criteria for prescribing by doctors, that could improve health of those using it. Who can quantify the worth of a medicine that helps you get your life back and move and feel like “everyone” else.
What to Expect if You Quit Taking glp1 Meds?
The first few weeks it won’t be noticeable that you stopped taking meds as everything is much the same. A few weeks more or a month after stopping hunger returns. Not the same dramatic, desperate hunger before someone starts — but a low-grade, persistent noise about food starts up again. The kind that makes you stand in front of the refrigerator at 9 p.m. not because you’re hungry exactly, but because your brain just won’t settle. The kind that makes portions slowly grow without your conscious permission. The kind that, over time will add pounds back.
I am Finding the Proper Dosage for Maintenance on My Own
My doctor visit and messaging after wasn’t sufficient for me as I couldn’t take a high dosage without getting sick. I made a plan to go down in dosage and reached out and asked for a lower dosage. My doctor answered by stepping me down a level. I think I need to go down a few levels of meds for less strength and still stay on a maintenance level. I filled a script for a lower dosage and will see how that goes this weekend. I am a live science experiment and so are the rest of us it seems
My doctor did say something I’ve thought about almost every day since: “The underlying metabolic condition doesn’t go away when you reach your goal weight, any more than high blood pressure goes away when your numbers normalize on medication.”
I sat with that for a second.
We don’t expect someone on a blood pressure medication to eventually “earn” getting off it by demonstrating sufficient willpower. We don’t tell a person on thyroid medication that they should be able to manage their thyroid through lifestyle alone if they just try hard enough. These are physiological conditions that respond to treatment. Stopping the treatment doesn’t cure the condition — it just removes the management tool.
This is my goal now, take a low maintenance dose — significantly lower than what I’d been using while I lost all the weight. Could that keep those cravings down, without the aggressive suppression needed when I was losing weight? Why can’t anyone help me answer that question? That’s the only way I could see staying on meds long-term. They had to be a lower dosage with less affect on my stomach. It wasn’t so much about the scale anymore. It was about keeping the up the habits I’ve been developing about how much to eat, when to eat and what to eat. Now it had to be directed more to maintenance rather than pure weight loss. Choosing to stay on medication is not a failure of willpower. It is a medical decision, made with a doctor, based on individual physiology. Those are completely different things.
Finding a Low Dose — and Staying There
My plan is to find out how a low dose works and go on more of a maintenance eating plan to slow down my weight loss. That means increasing calories and food and not gaining weight. I never figured this out before but I think it will work for me this time. The glp1 meds are in my back pocket know. They are a tool for me but not the answer to my problems, a tool in a tool belt. My knowledge has increased about how I need to eating enough protein and drinking enough water and continuing to move. My habits — the protein, the movement, the sleep, the weekly weigh-in — are all still in place. So, the medication isn’t doing all the heavy lifting anymore. My end goal is to get take a low dosage, and they keep the noise at a level where my habits can work.
What I am Telling People Now
I stopped being embarrassed about taking a glp1 med a few months after starting it. I wasn’t sure it would work for me. I didn’t take all the pictures and hopeful things everyone seems to do on tiktok. But I was hopeful that this would work. I just didn’t share it. Now, I feel differently about it. I am not embarrassed because I am not really any different than anyone else struggling with weight. Partly because I felt good about losing weight with it. Partly because I started being honest and talking to people about it. Someone would congratulate me on my hard work and I still have to tell them “I cheated”. Don’t think I did this on my own. Glp1 meds helped me accomplish something that will power alone couldn’t. I’m good with that and okay telling people. This might just work for you too.
A lot of people are quietly scared they’ll start glp1 meds and need to stay on it. A lot of people feel shame about that possibility before they’ve even made the decision. I want to say directly to those people: the shame is the wrong response to the situation. You wouldn’t shame yourself for staying on a medication that manages a chronic condition. This is no different.
In doing my own research on tapering off and if people are doing that or staying on the meds, it’s a bit of both. Some people stop and some people keep taking the meds and some have stopped to see what happens and have restarted. Not everyone will stay on a glp1 indefinitely. Plenty of people taper off successfully and maintain well without it — and that’s genuinely great. Every physiology is different. Some people have underlying conditions that absolutely warrant long-term use; others don’t. Some doses work differently at maintenance; some people find the lowest available dose is still too suppressive for where they are.
This is me saying: if you’re wrestling with this decision about whether to start taking glp1 meds, the answer lives in a conversation with your prescriber — not in a comment section, not on a Reddit thread, and definitely not on Instagram, where everyone has an opinion and exactly zero of them know your labs.
Talk to your doctor. Be honest about what you’re experiencing. Ask for a plan and what to expect. Ask about how to lose weight and stay strong. Ask about what happens when you get to the weight you want. Ask about maintenance dosing specifically. And give yourself permission to make a medical decision based on your own body, not on what sounds best to people who aren’t living in it.
Disclaimer: I’m not a doctor, dietitian, or pharmacist. This reflects my personal experience and general information only — not medical advice. Talk to your prescriber about your specific situation.
Stay steady out there,
Alex — Steadyafter50.com