Beyond weight loss: the critical role of long-term maintenance

Medication titration: an effective approach to maintenance

Maintenance begins when a patient has achieved their target weight through nutrition therapy, behavioral and mental health therapy, sleep and physical activity support, and potentially the use of GLP-1 therapy. At this point, the care provider shifts the goal to identifying a more sustainable GLP-1 dosing, where the patient still preserves their health outcomes. A 2026 case series shows preliminary evidence that reduced frequency dosing—typically every other week—maintained weight, body composition, and metabolic parameters in patients who had achieved weight plateau on weekly therapy.

When clinically appropriate, lower or reduced frequency dosing as part of a long-term outlook can help plan sponsors maximize their investment in GLP-1 coverage. Depending on pricing and a plan sponsor’s benefits strategy, if clinically indicated, less frequent dosing may be able to decrease an organization’s GLP-1 costs by 50% while the people they cover continue to benefit from the weight loss and cardiometabolic improvements from GLP-1s.

Weight maintenance after GLP-1s: separating scalable outcomes from selective results

Some programs point to their own internal analyses suggesting that select populations can maintain weight loss after stopping GLP-1 treatment. Discontinuation can be enticing to plan sponsors, but the broader body of clinical evidence shows that abrupt discontinuation often leads to weight regain and a loss of cardiometabolic benefits.

Abrupt discontinuation isn’t a sustainable GLP-1 strategy, and it’s why weight maintenance deserves greater attention in GLP-1 conversations. For plan sponsors designing benefits at scale, clinically appropriate weight maintenance allows them to balance coverage and costs for the broader workforce.

Ongoing clinical support is critical to successful weight maintenance

Since joining Teladoc Health, I’ve spent a lot of time talking with benefits decision makers about their weight and obesity care strategy. So much of their attention is paid to medication initiation and ensuring the right people have access to GLP-1s.

It starts with access to licensed care providers with expertise in obesity and cardiometabolic health, as well as obesity-specific training for all participating providers to complement their existing weight management experience. With this level of expertise, trained care providers guide members through clinically appropriate prescribing, slowly increasing the GLP-1 dose as needed, helping patients manage side effects, and helping them integrate nutrition, physical activity, sleep and stress management into their initial treatment.

The same clinical support is critical to long-term treatment pathways and effective weight maintenance. Many of the same expert recommendations during dose escalation when a patient begins taking a GLP-1 apply to titrating or adjusting the frequency of the medication if needed.

Every patient is an individual and responses may differ. Guidelines acknowledge that some patients may achieve strong responses at reduced dosage. This can begin with reducing the frequency of dosage—often from weekly to biweekly—or slowly reducing the dose over at least 20 weeks. While titrating doses, care providers must regularly monitor the patient, their weight, metabolic health, appetite and muscle strength. It's also critical that they reinforce nutritional and behavioral interventions that must accompany anti-obesity medications. 

If a patient is unable to maintain results, care providers may be required to re-increase dosage if weight regain exceeds 5%.

The value of a long-term GLP-1 treatment pathway

Emerging real-world evidence is showing us that plan sponsors can have it all when it comes to their weight and obesity care strategy. They don’t need to decide between ongoing GLP-1 coverage and controlling costs while sacrificing health outcomes.

It’s time to stop overlooking weight maintenance as a critical phase in an individual’s GLP-1 journey. Once someone has reached their target weight, the goal should be finding a sustainable and effective dose and supporting them to continue the behavioral interventions that are foundational to sustained weight management.

When maintenance is treated as an intentional phase of care, patients can sustain results while avoiding the costly cycle of stopping, regaining weight and restarting therapy.