Finding Your Perfect Zepbound or Mounjaro Maintenance Dose After Reaching Goal Weight

Why Everyone Assumes There Is One Right Maintenance Dose

When I first reached my goal weight after eleven months on Mounjaro and Zepbound, I had this naive expectation that my doctor would tell me exactly what dose to take for maintenance and that would be that. Simple. Clear. Done. Instead, he looked at my chart, smiled in that kind way doctors smile when they are about to tell you something complicated, and said the words that would haunt me for months: “We will need to experiment a bit to find what works for your body.”

Experiment. That word made it sound fun and scientific, like we were conducting research together. What he meant was that I was about to spend the next six months as a human trial participant in my own personal maintenance dose study, complete with data tracking, weight fluctuations, and a whole lot of second-guessing.

The medical literature talks about maintenance dosing as if it follows a predictable pattern. The clinical trials suggest that most people who reach goal weight can maintain their results on either their current dose or a slightly lower dose. The package inserts provide tidy dose escalation schedules going up and equally tidy de-escalation schedules coming down. Everything looks so organized on paper.

Real life, as it turns out, is significantly messier than clinical trial protocols.

The Medical Textbook Version Versus My Actual Body

According to the research I read obsessively during this period, the standard approach to maintenance dosing follows a relatively straightforward pattern. You reach your goal weight on whatever dose got you there. You stay at that dose for a month or two to stabilize. Then you either maintain that same dose or try reducing by one level to see if you can sustain your results with less medication.

For Zepbound and Mounjaro, the dose escalation schedule moves up in 2.5mg increments every four weeks minimum, starting from the 2.5mg initiation dose and potentially going all the way to the maximum dose of 15mg. The FDA-approved maintenance doses for weight management on Zepbound are 5mg, 10mg, or 15mg weekly. Some people stay on the intermediate doses of 7.5mg or 12.5mg if those work better for their bodies.

The theory makes perfect sense. Why take more medication than you need? If a lower dose can maintain your weight loss and metabolic improvements, reducing the dose means fewer potential side effects, lower costs, and less medication circulating in your system. The medical logic is sound.

My body apparently missed the memo about following medical logic

I reached my goal weight on the maximum dose of 15mg weekly. My doctor and I agreed that the reasonable next step was to try dropping to 10mg for maintenance. I had been tolerating the higher dose well, but I did still experience some lingering nausea and that slightly off feeling that accompanied each injection day. Reducing the dose seemed like it would address those issues while hopefully maintaining my weight.

Week one on the reduced dose felt fine. The Second week felt mostly fine. Week three started to feel different in ways I could not quite articulate. By week four, I knew something had shifted. The constant background noise about food that had been blissfully silent for months had started whispering again. Not screaming. Just whispering. Quietly suggesting that I think about lunch at 10:30 in the morning. Mentioning that the crackers in the pantry existed. Reminding me that I had not checked the refrigerator in at least an hour.

I stuck with 10mg for two full months because I kept thinking my body needed more time to adjust. I kept telling myself that the increased hunger was probably just psychological, that I was imagining it, that I should be able to maintain my weight on less medication if I just tried harder. The scale crept up three pounds. Then five pounds. Then seven pounds.

That is when I had my first real conversation with myself about what maintenance actually meant.

When Lower Doses Stop Working and Guilt Shows Up Uninvited

Going back up to 15mg felt like admitting defeat. I know that sounds dramatic, but the emotional weight of that decision surprised me with its heaviness. My goal. was reached. I had done the hard work. I had lost the weight. Needing the maximum dose just to maintain that loss felt like evidence that I had somehow failed at the maintenance part of the equation.

My doctor did not see it that way at all. When I showed up for my appointment feeling embarrassed about the seven-pound regain and asked to go back to the higher dose, he looked genuinely confused about why I seemed upset. He explained that maintenance doses vary enormously between individuals based on factors we do not fully understand yet. Some people maintain beautifully on 5mg. Others need 10mg or even 15mg to maintain their results long-term.

He reminded me that the goal was not to take as little medication as possible. The goal was to maintain my health improvements and quality of life using the dose that actually worked for my specific biology. If that dose happened to be 15mg, the maximum FDA-approved dose, then that was simply the dose my body needed.

The logic made sense intellectually. Emotionally, I still felt like I needed less. Like needing more medication meant my willpower was weaker or my metabolism was more broken or something fundamental about me was more difficult than it should be.

I went back to 15mg. Within two weeks, the food noise quieted back down. In just a month, the seven pounds disappeared. Within six weeks, I felt stable again.

You would think that would have been the end of my maintenance dose journey. It was actually just the beginning.

The Dose That Works Until It Suddenly Does Not

I maintained successfully on 15mg for three months. The scale stayed stable within a two-pound range. My appetite felt manageable. Life felt normal in the best possible way. Then insurance decided to get involved.

My insurance company sent a letter informing me that they would no longer cover the 15mg dose for weight management maintenance. They would cover up to 10mg monthly, but anything above that would require a prior authorization demonstrating medical necessity beyond weight maintenance. The appeal process could take weeks. The out-of-pocket cost for 15mg was substantially higher than I could sustain month after month.

This forced me back into dose experimentation, except this time it was not my choice. I had to figure out if I could make a lower dose work because the alternative was paying $500 per month out of pocket.

I tried 10mg again, this time with much lower expectations and much more careful tracking. Then, I logged my hunger levels three times daily on a scale from one to ten. I weighed myself every three days instead of obsessively checking daily. I paid attention to energy levels, mood, food thoughts, and physical satiety signals.

At 10mg, my average daily hunger hovered around a six out of ten. At 15mg, it had been consistently around a three. That difference between a six and a three might not sound dramatic, but it translated to spending a significant portion of every day thinking about food instead of thinking about basically anything else.

I lasted six weeks before the mental exhaustion of constant appetite management became unsustainable. I filed the prior authorization, fought with my insurance company for three weeks, and eventually got approval to return to 15mg.

The Microdosing Experiment Nobody Recommended

Somewhere during my insurance battle, I stumbled across information about people using lower-than-approved doses for maintenance. Not 10mg or 7.5mg, but doses like 5mg or even 2.5mg weekly, even though the 2.5mg dose is technically labeled only for treatment initiation and not intended as a maintenance dose. The research on this approach was limited but intriguing. Some studies suggested that lower maintenance doses could provide enough appetite regulation to support weight maintenance in people who had already established new habits and metabolic baselines.

My doctor had never mentioned staying on 2.5mg or 5mg as long-term maintenance options, possibly because clinical guidelines recommend 5mg as the minimum maintenance dose for weight management. But I was desperate to find something that worked better than the binary choice between struggling at 10mg or paying a fortune for 15mg.

I proposed the idea during my next appointment. To his credit, my doctor did not dismiss it immediately. He acknowledged that some of his patients had experimented with extended dosing intervals or lower doses with mixed results. He agreed to support a trial if I committed to close monitoring and agreed to increase the dose immediately if I started regaining weight.

I tried 5mg weekly for eight weeks. The first two weeks felt surprisingly okay. Weeks three through five were rougher. By week six, I was hungry enough that I knew this was not sustainable long-term. The experiment taught me something valuable though. My body seemed to have a minimum threshold of medication below which appetite regulation simply disappeared. That threshold sat somewhere between 5mg and 10mg, which meant I needed to find dosing options in that middle range.

Split Dosing and the Game-Changer I Did Not See Coming

During one of my marathon research sessions, I came across a discussion about dose splitting. Instead of taking one larger injection weekly, some people were dividing their dose into two smaller injections spread throughout the week. The theory suggested that more frequent, smaller doses might provide more stable medication levels and more consistent appetite control.

I brought this idea to my doctor with low expectations. He surprised me by saying that several of his patients had tried this approach with good results. The challenge was that Zepbound and Mounjaro come in specific single-dose pens and vials, which makes precise dose splitting complicated.

We decided to try something creative within the constraints of available pens. Instead of one 10mg injection weekly, I would try using a 5mg pen twice weekly, approximately every three to four days. This gave me the equivalent of 10mg per week but spread across two smaller doses.

The difference was remarkable. The twice-weekly dosing pattern provided noticeably more consistent appetite control than the once-weekly larger dose. I no longer experienced the subtle increase in hunger that used to creep in around days five and six after each injection. My energy levels felt more stable throughout the week. The total weekly dose remained at 10mg, which was lower than the 15mg that had worked perfectly for me previously, yet the split dosing made it significantly more effective.

I maintained this pattern for a few months with excellent results. My weight stayed stable. My hunger stayed manageable. The food noise stayed quiet. I felt like I had finally cracked the code on my personal maintenance dose.

Then the pen shortages happened and suddenly my twice-weekly dosing strategy became logistically and financially impossible.

Learning to Accept That Maintenance Means Ongoing Adjustment

After eleven months of dose experimentation, insurance battles, pen shortages, and more self-tracking than any human should have to do, I finally accepted a fundamental truth about maintenance dosing. There is no perfect, permanent dose that will work flawlessly forever. Maintenance is not a destination where you arrive and then coast. It is an ongoing process of paying attention, adjusting, and responding to what your body needs in different circumstances.

My maintenance dose has changed based on stress levels, activity changes, sleep quality, hormonal fluctuations, and probably seventeen other variables I have not identified yet. What worked perfectly in June needed adjustment by September. What felt too high in winter felt necessary by spring.

I eventually settled into a flexible maintenance approach rather than searching for one magic dose. Most months I take 10mg weekly and that works well. Some months I need to bump up to 15mg for a few weeks when life gets stressful or my appetite seems less regulated. Occasionally I try splitting my 10mg dose into two 5mg injections when I can access the right pens. I have learned to recognize my personal hunger signals that indicate a dose is too low before significant regain happens. I have also learned to identify the side effect patterns that suggest a dose is higher than I currently need.

This flexibility required me to let go of the idea that needing more medication sometimes meant I was doing something wrong. It required accepting that my body has specific needs that might not match the average patient in clinical trials. It required trusting myself to make adjustments based on real signals rather than guilt or shame about how much medication I thought I should need.

What Your Body Is Actually Telling You About Dose Adjustments

One of the most valuable skills I developed during my maintenance dose journey was learning to differentiate between real physiological signals and emotional noise. This distinction became critical for making good decisions about dose adjustments.

When a dose is genuinely too low for my body, specific patterns emerge. Physical hunger increases in a measurable way. I notice myself thinking about food more frequently throughout the day, not just at mealtimes. The sensation of satiety after eating becomes less pronounced and shorter-lived. I start experiencing the urge to snack between meals even when I am not physically hungry. These are biological signals indicating that the medication is not providing adequate appetite regulation.

When a dose is higher than I currently need, different patterns appear. I might feel slightly nauseous on injection days. Food can start seeming less appealing in general, to the point where eating adequate nutrition requires conscious effort. I might notice mild digestive discomfort or that slightly off feeling that suggests my body is working harder than necessary to process the medication.

Learning to read these signals took time and required honest self-assessment. The tricky part was distinguishing between genuine physiological feedback and the emotional stories I told myself about what dose I should need. My brain wanted to believe that needing less medication meant I was succeeding better at maintenance. My body kept providing clear feedback that it needed what it needed regardless of what my ego preferred.

I started keeping a simple daily log noting three things: hunger level on a scale of one to ten, overall energy, and any side effects. Over time, patterns became visible that helped guide dose decisions based on data rather than feelings. When my hunger average crept above five for more than a week, I knew the dose needed adjustment. When I experienced nausea more than once per week, I knew the dose might be too high.

This tracking felt tedious initially but became second nature. More importantly, it gave me concrete information to share with my doctor rather than vague feelings about whether something was working.

The Emotional Journey of Needing More Than Expected

Perhaps the hardest part of my maintenance dose journey had nothing to do with the actual medication. The hardest part was working through the guilt and shame I felt about needing a higher dose than I thought I should.

I kept comparing myself to other people in online support groups who maintained their weight loss on lower doses. The entire time, I kept wondering why my body seemed to require more help than theirs. I kept feeling like needing the maximum dose somehow proved that I was more broken or more dependent or less capable of maintaining my results through lifestyle alone.

These feelings were not rational. Intellectually, I understood that medication needs vary between individuals based on countless factors. I knew that some people can maintain healthy blood pressure on small doses of medication, while others need multiple medications at higher doses. I knew that the dose you need says nothing about your worth or effort or capability.

Knowing something intellectually and believing it emotionally are completely different processes.

Working through this required some difficult but necessary perspective shifts. It was necessary to accept that my body has specific biological needs that are not moral failings. I had to recognize that judging myself for needing a certain dose was as illogical as judging someone for needing glasses, thyroid medication, or insulin. I had to internalize the understanding that taking medication long-term is not a sign of weakness but a legitimate medical intervention for a chronic condition.

The turning point came when I reframed what success meant. Success was not taking the smallest possible dose or getting off medication entirely. Success was maintaining my health improvements, keeping the weight off, preserving my mental peace around food, and living my life without constant food noise. If achieving that success required a higher maintenance dose, then that dose was exactly the right dose for me.

This reframing did not happen overnight. I worked through a lot of self-judgment before reaching a place of acceptance. But getting to that place made all the difference in how I approached maintenance dosing going forward.

Practical Wisdom After Months of Trial and Error

After experimenting with five different maintenance dosing strategies, I learned some practical lessons that might help other people navigating this phase.

First, give each dose adjustment adequate time before deciding whether it works. I learned that my body needed at least four to six weeks to fully adjust to a dose change. Making decisions based on the first two weeks led to unnecessary dose hopping that created more instability than it solved.

Second, track objective data rather than relying solely on how you feel. Feelings are important, but they can be influenced by so many factors beyond the medication. Weight trends over time, consistent hunger patterns, and specific side effect frequency provide more reliable information for dose decisions.

Third, work with your healthcare provider as a collaborative partner rather than waiting for them to tell you what to do. I learned that my doctor had expertise about medications, but I had expertise about my body. The best decisions came from combining both types of knowledge.

Fourth, be willing to advocate for approaches that might fall outside standard protocols. Dose splitting, microdosing, and flexible dosing schedules are not always in the official guidelines, but they work well for some people. If you have done your research and think something might help, it is worth discussing with your provider.

Fifth, accept that your maintenance dose might change over time and that is completely normal. What works perfectly right now might need adjustment in three months or six months or a year. Building the skills to recognize when adjustments are needed matters more than finding one permanent dose.

Finally, let go of comparison and judgment about what dose you need. Your maintenance dose is whatever dose maintains your results while supporting your quality of life. That dose is the right dose, regardless of what anyone else takes or what you think you should need.

Where I Landed After the Dose-Finding Journey

These days, I take 10 mg of Zepbound most weeks for maintenance. Some weeks I bump up to 12.5mg if stress is high or my appetite seems less controlled. I no longer feel guilty about those adjustments. I understand that my body has variable needs and I have the tools to respond appropriately.

The scale stays within a five-pound range, which I have learned to accept as normal fluctuation rather than evidence of failure. My hunger stays manageable most days. The food noise that used to dominate my mental space remains mostly quiet. I can go hours without thinking about my next meal, which still feels miraculous after spending decades with food as a constant background concern.

I still track my hunger levels a few times per week, not obsessively but consistently enough to catch patterns before they become problems. Yet I still weigh myself every few days to monitor trends. I still pay attention to how my body responds to different doses and circumstances. This ongoing attention is not a burden anymore. It is simply part of managing a chronic condition effectively.

My Personal Lessons Learned

The dose-finding journey taught me something more valuable than just which milligrams to inject each week. It taught me to trust my body, advocate for my needs, and let go of arbitrary standards about what maintenance should look like. It taught me that individualized medicine means accepting that your path might not match anyone else’s path, and that is not only okay but exactly how it should be.

My body does not read the medical textbooks, nor does it follow the clinical trial protocols. It does not care about my ego or my guilt or my ideas about what dose I think I should need. It simply responds to what it receives and provides clear feedback about whether that is adequate or not.

Learning to listen to that feedback, trust that information, and respond with compassion rather than judgment transformed my entire maintenance experience. The right maintenance dose is not the lowest dose or the most common dose or the dose that sounds most impressive to other people. The right maintenance dose is whatever dose allows you to maintain your results while living your actual life.

For me, that dose turned out to be higher than I expected and more variable than I would have preferred. But it works. And ultimately, that is all that matters. Love yourself and Love Your Journey.