Long on Meds Blog
Should I Stay on a GLP-1 Drug After I Reach a Healthy Weight?
GLP-1 based medications have changed the treatment of obesity and diabetes, and their benefits increasingly extend beyond weight loss. But what happens when you reach a healthy weight? Should you stop the medication, or could there be reasons to continue it?
I faced that question myself after losing approximately 25 to 30 pounds with tirzepatide. I chose to continue taking a much smaller amount. My reasons begin with weight maintenance, but they extend to quality of life and the emerging evidence that these medications affect inflammation and several organ systems.
Why did I start taking tirzepatide?
I had been a runner for most of my adult life. After rupturing my quadriceps tendon, however, I was unable to run normally for roughly two years. During that period my weight increased from around 150 pounds to approximately 175 to 177 pounds.
I had difficulty getting the weight off through diet alone, so I started tirzepatide.
The effect surprised me. Controlling how much I ate suddenly became remarkably easy. I concentrated on protein, vegetables, fiber, and adequate fluids, and within about three to four months I had lost approximately 25 to 30 pounds.
What changed after I lost the weight?
The number on the scale was only part of the benefit.
When I returned to around 150 pounds, running became easier and my joints hurt less. Moving around was easier. My clothes felt better. My gastrointestinal function became extremely reliable.
Some of those changes may have resulted directly from tirzepatide. Others may have resulted from losing weight or improving my diet. I cannot separate them.
What I can say is much simpler:
I felt much more comfortable in my own skin.
That improvement in everyday quality of life became an important reason I did not want to give the medication up.
Don't people regain weight when they stop?
Frequently, yes.
In the randomized SURMOUNT-4 trial, people who had successfully lost substantial weight with tirzepatide were either continued on the medication or switched to placebo. Those who stopped tirzepatide regained substantial weight, while those who continued treatment maintained or extended their weight loss.
That supports an increasingly important concept: for many people, obesity behaves like a chronic condition. Successful weight loss does not necessarily mean the underlying tendency toward weight gain has disappeared.
Aren't I concerned about becoming too thin or losing muscle?
Absolutely. For an older adult, preserving muscle is at least as important as losing excess fat.
At 75, my current weight is about 147 pounds and my BMI is approximately 23. A home bioimpedance scale estimates my body fat at about 16%, although I regard those consumer measurements as estimates rather than precise body-composition testing.
More important to me is function. I continue to run, walk, use a stepper, perform leg presses and other resistance exercises, and do chin-ups. I also make adequate protein an important part of my diet.
Clinical studies show that some lean tissue is lost during substantial tirzepatide-induced weight loss, although considerably more fat than lean mass is lost. That makes resistance exercise, adequate nutrition, and preservation of strength particularly important for older adults using these medications.
How do I keep my weight from continuing to fall?
I have adjusted my own regimen to approximately 3.3 mg of tirzepatide every 10 days.
This is important: that is my personal regimen, not an established or clinically tested maintenance schedule.
For roughly the first week after an injection, my appetite is substantially reduced. During the last few days before the next injection, my appetite returns. I like that rhythm. I enjoy eating, and I don't want my appetite permanently eliminated.
My objective is no longer continued weight loss. It is to maintain the weight and quality-of-life improvements I achieved without becoming progressively thinner.
Could GLP-1/GIP drugs provide benefits beyond weight control?
Increasingly, the answer appears to be yes—at standard therapeutic doses and in appropriately selected patient populations.
Research with tirzepatide and other GLP-1 based therapies has demonstrated effects extending beyond weight loss. Tirzepatide reduces inflammatory markers including hsCRP and IL-6. Clinical trials have also reported benefits involving obesity-related heart failure, kidney measures, sleep apnea, and metabolic liver disease. Semaglutide has demonstrated cardiovascular-event reduction in people with overweight or obesity and established cardiovascular disease even without diabetes.
These findings make it increasingly difficult to think of GLP-1 based medications simply as "weight-loss drugs."
But there is an important limitation: we do not yet know whether normal-weight people receive these same organ-protective benefits from very-low-dose maintenance therapy. The major outcome trials used conventional therapeutic doses in people with specific medical conditions.
So why have I chosen to stay on tirzepatide?
Because my decision is based on more than the scale.
I experienced a substantial improvement in quality of life. Maintaining my weight became easier. Running became easier and less painful. My gastrointestinal comfort improved. I have maintained a healthy weight while continuing to exercise vigorously and preserve my strength.
At the same time, an expanding body of research suggests that GLP-1/GIP therapy affects inflammation, metabolism, cardiovascular health, and several other organ systems.
I am not claiming that my very-low-dose regimen has been proven to extend life or provide those same organ-protective effects. It has not.
I am making a personal risk-benefit decision: I tolerate tirzepatide well, I experience meaningful quality-of-life benefits from remaining on it, and I find the broader biology increasingly compelling.
That is another example of the third level of Long on Meds: once the original therapeutic objective has been achieved, asking whether a carefully selected low-dose medication still offers enough potential benefit, at sufficiently low risk, to justify discussing continued treatment with your physician.
Learn more about inflammaging and inflammatory pathways, or use Check a Medication to examine GLP-1/GIP medications and other therapies.