That seems like a lot just for maintenance
There is really no evidence that maintenance doses should be any different to the doses required to lose the weight, assuming you are no longer losing weight while taking that dose, which is what all the studies show. After losing how ever many percent on the drug the weight line on the graphs stays flat over long periods of time on that dose. Results people often describe on this forum of getting to target weights and not getting stuck halfway are not typical of the trial results, partly due to be a highly selected motivated population and partly due to stacking other additional agents.
The long term success rates of people losing that amount of weight and keeping it off long term are very tiny, a few percent at best prior to glp's. ( without surgery ) And so far there really is not much research on long term effects with these drugs as there has not been enough time yet. Which is consistent with my previous experience of succeeding in getting to normal BMI's but never being able to stay there for long, after suddenly becoming obese at the age of 7 .
After losing most of the weight , my weight stayed stable for about a year but it was hard. Despite walking 3 to 11km per day and eating 1600 to 1800 kcal per day, I was more or less hungry all the time, despite eating a diet specifically designed by me to minimise hunger, low calorific density, high protein , low glycaemic index, low fat , basically lean meat, fruit and vegetables.
I started on semaglutide which made me nauseous, but reduced hunger a bit, and eventually discovered cheap Chinese peptides that gave me more options. The current doses are just what I have gradually worked out over time to hopefully make staying in the normal BMI range possible, so that despite tirzepatide plus a bit of reta plus a new experiment with low dose cagrilintide, I am still sticking to a diet of absolute and complete avoidance of any high calorific density highly rewarding foods, and all of that is required to keep the weight off. If I ever get to a point where I am still even slowly losing weight and would prefer not to lose more weight , which I think is not really that likely , then reducing doses or simplifying the medications would be a good idea.
Relying on willpower to keep weight off long term in the presence of extreme hunger basically will always fail. And in people with severe obesity the system that regulates appetite is broken , which is why they have severe obesity, and is possibly not fixable without ongoing treatment.
For most people , especially those with more severe obesity , the main problem is that these medications are not good enough yet.
