Reaching your goal weight: how maintenance works at Belle

Reaching your goal is a big milestone. The next step is maintenance: keeping your results steady. Most people start by staying at their current dose for about 4 weeks so their weight settles. After that, the usual options are to stay at the dose that is working, step your dose down slowly (on tirzepatide, usually 0.5 to 1 mg every 2 to 4 weeks), or keep your dose and go longer between shots (for example every 10 to 14 days, or every other week). Your provider and care team set the details with you.

Two things called "maintenance"

1. The maintenance plan on your intake form. Choosing "Stay at same dose" at sign-up puts you on what we call the maintenance plan: your dose does not step up each month.
2. Maintenance after you reach your goal. This is the plan you and your care team make to hold your results.

They are different things, and neither one is the same as the Microdose plan (see below).

I hit my goal. What now?

Stay at your current dose for about 4 weeks so your weight can settle and stop fluctuating. Then choose, with your care team, one of these:

• Stay where you are. If your current dose holds your weight, you can stay at it long term.
• Step your dose down slowly. You lower your dose in small steps until you are no longer actively losing and your weight holds steady.
• Keep your dose and space out your shots. Some people go every 10 to 14 days, or every other week, at the same dose.

To start, just message us and tell us you have reached your goal. Changing to a maintenance dose is just a message: there is no visit, call or form. Your care team confirms it with your provider and updates your plan, usually the same day or the next business day.

Is there a typical maintenance dose?

No. Your maintenance dose is whatever dose holds your weight steady without active weight loss, and it is different for everyone.

How do I step down?

• Tirzepatide: people usually lower their dose by 0.5 to 1 mg every 2 to 4 weeks, until they are no longer actively losing and their weight holds.
• Semaglutide: the steps are smaller, and your nurse sets them for you.

Finding the units for each lower step. How many units you draw depends on the strength of your vial, so always use the concentration printed on the vial you are using now. You can work out the units for each lower dose yourself with Belle's dosage calculator (see "How do I use Belle's dosage calculator?"), and let your care team know you are stepping down so your plan and records match. If you are not sure the number is right, message us before you inject.

Can I space out my shots?

Yes, once you have reached your goal. You keep the same dose and go longer between injections, for example every 10 to 14 days or every other week. Until you reach your goal, stay at one injection every 7 days.

If you would like to try spacing out your shots, message us and we will help you set it up.

Please do not go longer than 14 days between injections. A longer gap can bring side effects back when you inject again, and after more than 4 weeks without a dose you would need to restart at a lower dose. You do not have to space out: staying weekly at a lower dose is fine too.

Can I switch to the Microdose plan?

The Microdose plan can be a way to stay at a low dose once you have already stepped down to around 5 mg of tirzepatide. It is not a jump from a high dose: step down first. Switching is a new order, so your current plan is cancelled and you complete a short questionnaire; message us and we will send you the link. See "What is microdosing a GLP-1?" for how the plan works.

Can I just stop?

You can stop without tapering, but we usually recommend stepping down first, because it helps you hold your results. After stopping, appetite often returns and some weight regain is common. That is normal biology (your body defends its weight), not a lack of willpower. The same habits below help whether you are on medication or off it.

If you stop and later want to restart, how you restart depends on how long it has been since your last shot. See "What if I miss my scheduled injection day?" for the restart guidance.

How long does maintenance last?

As long as it is working for you. Some people stay on a maintenance dose long term, and others step down and come off over time. The brand-name versions of these medicines are approved for long-term weight management.

My appetite came back after I lowered my dose

Some return of appetite is common when your dose comes down. Protein at every meal, fiber, and regular meals help. If hunger is hard to manage, or the scale keeps climbing, tell us and we will get your provider's view.

My weight is creeping back up

Small ups and downs are normal, so watch the trend, not the daily number. If your weight is still climbing after 2 to 4 weeks, message us and we will get your provider's view on your plan.

If your weight keeps climbing as you step down, the lower dose may be too low for you. A common approach is to move back up gradually, lose the regained weight, and then try stepping down again after you have held your goal weight for several weeks.

Side effects on your current dose

Tell your care team before your next injection. Common triggers are a dose that is too high, not enough protein before injecting, dehydration, not eating enough, or overeating and heavy, processed or fatty foods. Your care team can lower your dose or talk through options. See "GLP-1 side effects and what's normal". Do not jump back to the starting dose on your own; your provider will tell you what to restart at.

Does maintenance change my price?

No. Your price does not change with your dose.

I am using less medication. What about my shipments and my vial?

• Shipments: if your supply is lasting longer, pause or delay your next refill in the patient portal, or message us and we will move the date for you.
• Your vial: use each vial only up to the beyond-use date (BUD) printed on its label, never after it. You do not have to throw it away at 28 days; see "My vial label says to discard it 28 days after first use. Do I have to?".

Lock in lifestyle habits

• Regular meals with lean protein, fiber, and non-starchy vegetables.
• Minimize liquid calories and processed snacks.
• At least 150 minutes of moderate activity per week, including strength training.
• Quality sleep (7-9 hours).
• Weigh yourself weekly and track trends, not daily fluctuations.

Support while you maintain

• Free messaging with the care team, any time.
• Want to talk it through? We can book you a call with a nurse.
• Our dietitian hosts a free weekly live webinar.