For tirzepatide, a randomised trial has now tested stepping down. In SURMOUNT-MAINTAIN, people who had lost weight on 10 or 15 mg and then stepped down to 5 mg finished 16.6% below their starting weight at week 112, against 21.9% for those who stayed on the full dose and 9.9% for those switched to placebo (Horn 2026). On average, the lower dose held more of the loss than stopping did; individual results vary. For semaglutide, the US label lists 1.7 mg as well as 2.4 mg as a maintenance dose (US label). This article covers what "maintenance dose" means on the labels, what that trial found, and how a lower dose fits a plan that is designed to end.
Availability in Singapore. Both medicines are registered with Singapore's Health Sciences Authority, and their registered indications include weight management. Which medicine suits a particular person, if any does, is decided by the doctor who assesses them.
What "maintenance dose" means on the label
Not what most people assume. On the labels, the maintenance dose is the dose reached after the starting escalation, used both while losing weight and for keeping it off. It does not mean a reduced dose for after the loss.
For tirzepatide, the maintenance doses are 5 mg, 10 mg and 15 mg once weekly; 2.5 mg is a starting dose and is not approved for maintenance, and the US weight-management label says a lower maintenance dose can be considered when one is not tolerated (EU SmPC, US label). For semaglutide, the US label gives 1.7 mg or 2.4 mg once weekly, with 2.4 mg recommended, and allows an increase to 7.2 mg where more weight reduction is clinically indicated (US label); the European label gives 2.4 mg, with 7.2 mg as an option (EU SmPC). Can you stay on the lowest dose of Mounjaro (tirzepatide), 2.5 mg? sets out what the labels and the studies show.
So the question "is a lower dose enough to keep it off?" is a separate one, and SURMOUNT-MAINTAIN, published in 2026, asked it directly.
The trial that tested stepping down
SURMOUNT-MAINTAIN gave adults with obesity tirzepatide at the highest dose they tolerated, 10 or 15 mg, for 60 weeks. They were then randomised to one of three paths for another 52 weeks: stay on that dose, step down to 5 mg, or switch to placebo (Horn 2026).
| Path for weeks 60 to 112 | Weight change from the start, at week 112 | Given rescue tirzepatide |
|---|---|---|
| Stayed on 10 or 15 mg | −21.9% | 8% |
| Stepped down to 5 mg | −16.6% | 25% |
| Switched to placebo | −9.9% | 67% |
Rescue tirzepatide was offered once someone had regained more than half of the weight they had lost. The authors conclude that reducing to 5 mg "might provide a valuable alternative to discontinuation, although individuals' treatment response might vary" (Horn 2026). The trial was run in the United States in adults with a mean BMI of 40, and it was funded by the manufacturer. Those are averages in a studied population, and individual results vary: one in four people on 5 mg regained enough to be given rescue treatment.
Semaglutide: a lower dose on the label
For semaglutide, a lower maintenance dose is already on the label. The US label gives 1.7 mg or 2.4 mg once weekly, with 2.4 mg recommended, and tells prescribers to consider treatment response and tolerability when selecting the maintenance dose (US label). The SURMOUNT-MAINTAIN figures above are for tirzepatide, not semaglutide. At GetLean the semaglutide dose is reviewed the same way: at the monthly check-in with Dr Quek, working towards the lowest effective dose.
How a lower dose fits a plan designed to end
The principle a prescriber works to is the lowest effective dose: the smallest dose that still achieves the clinical goal, rather than the highest one a person can tolerate. How dose titration works covers it from the starting end.
A lower dose can be a step on the way off. We favour a gradual reduction under a doctor's guidance rather than a cliff-edge stop, which allows appetite to adjust incrementally. At GetLean, dose changes are made at the monthly check-in with Dr Quek, and the dose reviews work towards the lowest effective dose. Whether that ends at a lower dose or at none is decided with him as the response comes in.
At GetLean, the programme is designed to end: our philosophy is that GLP-1 medication should act as a catalyst — not something to depend on indefinitely. A lower dose is one of the tools for getting there, not a promise that it will hold for everyone.
Individual results vary, and clinical-trial figures describe the populations studied. Never change a prescribed dose on your own; that is a conversation with the doctor who prescribed it.
What happens after the taper at GetLean?
Finishing the taper does not have to end the support. After the taper, a patient can keep the daily WhatsApp coaching and the monthly reviews with Dr Quek by continuing the monthly subscription, if they wish. If the weight starts coming back, they can come back to Dr Quek at any time: a restart begins with a review consultation, and whether to restart the medication is his decision at that review.
Designed to end: a programme whose pace and taper off the medication are planned from the first consult, so the result holds after the medication stops.
Common questions
What is the maintenance dose of Mounjaro?
On the EU and US weight-management labels, the maintenance doses of tirzepatide are 5 mg, 10 mg and 15 mg once weekly; 2.5 mg is a starting dose and is not approved for maintenance (EU SmPC, US label). Which dose suits a person is the prescribing doctor's decision.
Can you stay on the lowest dose of Mounjaro (2.5 mg)?
On the EU and US weight-management labels, the maintenance doses of tirzepatide are 5 mg, 10 mg and 15 mg once weekly; 2.5 mg is a starting dose and is not approved for maintenance (EU SmPC, US label). Which dose suits a person is the prescribing doctor's decision. Staying below the labelled maintenance doses would be an off-label decision, one a doctor makes with a particular person and keeps under review; Can you stay on the lowest dose of Mounjaro (tirzepatide), 2.5 mg? sets out what the labels and the studies show.
What is the maintenance dose of Wegovy?
The US label gives 1.7 mg or 2.4 mg once weekly, with 2.4 mg recommended, and allows an increase to 7.2 mg in some patients (US label); the EU label gives 2.4 mg, with 7.2 mg as an option (EU SmPC).
Can a lower dose keep the weight off?
For tirzepatide, SURMOUNT-MAINTAIN tested it: people who stepped down from 10 or 15 mg to 5 mg were still 16.6% below their starting weight at week 112, against 21.9% on the full dose and 9.9% on placebo (Horn 2026); individual results vary. For semaglutide, the US label lists 1.7 mg as well as 2.4 mg as a maintenance dose (US label). Which dose suits a person is the prescribing doctor's decision.
Is a lower dose a way to come off?
It can be a step. We favour a gradual reduction under a doctor's guidance rather than a cliff-edge stop, which allows appetite to adjust incrementally. At GetLean, dose changes are made at the monthly check-in with Dr Quek, working towards the lowest effective dose, and whether that ends at a lower dose or at none is decided with him as the response comes in. Any change to a prescribed dose is a decision for the prescribing doctor.
What happens after the taper at GetLean?
A patient can keep the daily WhatsApp coaching and the monthly reviews with Dr Quek by continuing the monthly subscription, if they wish. If the weight starts coming back, they can come back to Dr Quek at any time; a restart begins with a review consultation, and whether to restart the medication is his decision.