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The dose people actually stay on

Twelve months in, 48% of one clinic's patients were still taking semaglutide — and 40% of those were maintained at 1.0 mg or less, well below where the trials ran.

Carla Medina6 min read
206 people, twelve months after starting38%stopped15%paused48%still on itOf the 48% still going, the maintenance dose was:1.0 mg or less40%1.7 mg30%2.4 mg30%A single general practice. Not a national estimate.

Almost every price on this roster is quoted as though a buyer will land on one dose and stay there. Almost every trial is run as though everyone escalates to the top. This study is a look at what a real clinic’s patients did instead, and it does not match either assumption — which matters, because the assumption is what the figure on the card is priced against. The related question of who is still paying anything at all is in two-thirds stop within a year.

What was observed

Researchers followed 206 people prescribed semaglutide for weight management in a single general practice [1]. Seventy-six percent were women, mean age was 48, and mean starting weight was 105 kg.

At twelve months, 78 people (38%) had permanently discontinued and 30 (15%) had paused treatment. Ninety-eight (48%) were still on it. Of those ninety-eight, 40% were being maintained at 1.0 mg a week or less, 30% at 1.7 mg, and 30% at 2.4 mg.

The result, with its clause attached

Mean relative weight change at twelve months was −13.6% (95% CI −15.0 to −12.2). That figure belongs to the 48% who had not discontinued. It is not what the average person who walked in and started treatment lost, and the study does not claim it is.

Read with that clause, it is still striking: the people who stayed on lower maintenance doses, reached by slower titration than the label describes, lost a great deal of weight. The authors’ own conclusion is that semaglutide is frequently discontinued and titrated more slowly and to lower maintenance doses in practice than in the approved labeling, and that the weight loss among those continuing was nonetheless substantial.

What it means for a price

If most people settle below the top of the ladder, then a flat rate is worth more than it first appears and a dose-scaled rate is less alarming than it sounds — provided the seller says which it is. On this roster 143 sellers state a flat figure and 35 state that the price climbs, out of 456. The remainder — 278 of them, 61% — say nothing at all, and silence is the one answer a buyer cannot plan against.

At the median billed figure of $179 a month, a year of injected semaglutide here is $2,148 if the price holds. Whether it holds is precisely what most of these sellers decline to say. Roster read September 2026, and the fee arithmetic behind the median is in what a GLP-1 actually costs.

The other implication is about expectations. A buyer comparing storefronts is implicitly planning a year of purchases; this study says slightly under half of a real clinic’s patients were still buying at month twelve, and what stopping costs is the part nobody puts on a pricing page.

Frequently asked

What dose do people actually end up on?
In this practice, among those still taking it at twelve months, 40% were maintained at 1.0 mg a week or less, 30% at 1.7 mg and 30% at 2.4 mg — slower titration and lower maintenance than the labeling describes.
How much weight did they lose?
Mean relative change was -13.6% at twelve months, with a confidence interval from -15.0 to -12.2. That figure describes the 48% still on treatment, not everyone who started.
Does this justify microdosing?
No. Every dose observed sits on the approved ladder at 1.0, 1.7 or 2.4 mg. What was unusual was the pace and the stopping point, not a rung below the licensed range.
How many people were studied?
206, in a single general practice. It describes how one clinic's patients were treated rather than estimating a national pattern.

Sources

  1. [1] Skandov MD, et al. (2026). Real-World Use of Semaglutide for Weight Management: Dose Titration, Discontinuation Patterns and Weight Changes Diabetes, Obesity and Metabolism. PMID 42420793

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