Partly, and there is now a trial that measures the cost of doing it. After 60 weeks on tirzepatide, 378 adults were randomized three ways for another 52 weeks [2]. Continue at the maximum tolerated dose, drop to 5 mg, or switch to placebo. At week 112, weight sat 21.9% below baseline on the full dose, 16.6% at 5 mg and 9.9% on placebo.
Rescue therapy tells the same story in a form a buyer can price. It was needed by 8% of those staying at full dose, 25% of those dropping to 5 mg and 67% of those stopping [2]. Halving the dose kept most of the benefit; stopping did not.
The maintenance question is usually posed as two answers. Keep paying the full monthly price indefinitely, or stop and watch about a kilogram a month come back. This paper argues that the space between those is where the actual decision lives.
The reframe
Regain after stopping, the authors suggest, may reflect the re-emergence of biological pressures favoring weight restoration rather than a failure of treatment. [1] That is not a semantic move. If regain is the body resuming a defended position, the question is how much ongoing pressure holds the line. That is a dose question, not a yes-or-no one.
They propose the term adaptive maintenance. It means the minimum intensity that preserves meaningful health benefit, weighed against relapse risk, treatment burden and what the patient wants.
What is established and what is not
Only one thing here has strong direct evidence: continued obesity medication limits weight regain. That comes from randomized withdrawal and maintenance trials, and it is the starting point rather than a recommendation about any individual.
Everything else is a proposal. Monitored dose reduction with predefined criteria for going back up. Switching to an oral formulation. Reduced-frequency dosing. Intermittent rescue therapy when weight starts to move. Structured lifestyle support. The paper lists these as potential strategies, not as validated ones.
The monitoring idea
The more interesting proposal is about catching relapse early. The authors suggest a set of early signals: appetite, satiety, food preoccupation, weight trajectory, waist circumference and cardiometabolic markers. Any of them may flag an emerging relapse before much weight returns. That would let a dose go back up before the ground is lost.
They also say these approaches require prospective validation. Nobody has demonstrated that watching those signals produces better outcomes than not watching them. It is a hypothesis with a plausible mechanism. The same caution applies as to what dose people actually settle at in practice, which is already lower than the trials used.
What a buyer can do with this
Not change anything unilaterally. Dose and schedule are prescriber decisions, and reducing a dose without one is how people lose the benefit they paid for.
What it does supply is vocabulary for a conversation most people never have. Somebody eleven months in, having reached their goal and facing an indefinite bill, currently has two options presented to them. There are at least six. Several are cheaper. The evidence for them is thinner, and all three facts belong in the same sentence when raising it with a clinician.
On price, the practical levers are the ones the paper names: dose and format. What each costs here is in the price check. Over years, a maintenance dose against a full one is the largest single variable in what this ends up costing over years rather than months.