If you’re using a GLP-1 weight loss injection such as Mounjaro® (tirzepatide) or Wegovy® (semaglutide), it’s natural to wonder what happens once the weight comes off.
- Can you stay on GLP-1 medication long term?
- Is there a maintenance dose?
Is there a BMI cut-off where treatment must stop?
This page explains GLP-1 maintenance treatment clearly and transparently, including the BMI threshold that applies in the UK. All decisions described here are made in line with the Patient Group Directions (PGDs) under which DoseDirect operates. The PGD is the final authority on eligibility.
What Is GLP-1 Maintenance?
GLP-1 maintenance refers to continuing GLP-1 medication after weight loss to help prevent weight regain.
Both Wegovy® and Mounjaro® are licensed in the UK for:
- Weight reduction, and
- Weight maintenance, when used alongside dietary changes and increased physical activity
Maintenance does not mean staying on the highest dose indefinitely. In clinical practice, a GLP-1 maintenance dose usually involves:
- Using the lowest effective dose
- Holding a dose steady rather than escalating
- Prioritising weight stability over further loss
Can You Stay on Mounjaro or Wegovy Long Term?
Some patients can remain on GLP-1 medication for longer periods, but continuation is never automatic.
Ongoing treatment depends on:
- Continued clinical benefit
- Safety and tolerability
- Remaining within eligibility criteria defined by the PGD
GLP-1 medicines are not intended to be lifelong by default, and all patients are reviewed regularly.
Why Is GLP-1 Maintenance Important?
Weight regulation is controlled by complex hormonal and metabolic systems — not willpower alone.
GLP-1 medicines help by:
- Reducing appetite
- Increasing fullness
- Slowing digestion
- Improving metabolic signalling
When treatment is stopped, these effects reduce. This is why weight regain is common after stopping GLP-1 injections, even when lifestyle changes are maintained.
Maintenance treatment may be appropriate for a period, but not indefinitely for everyone.
GLP-1 Maintenance BMI Cut-Off (UK)
What Is the BMI Cut-Off for GLP-1 Maintenance?
Under the UK Patient Group Directions for Wegovy® and Mounjaro®, continued treatment for weight management is only permitted while:
BMI remains at or above 22 kg/m²
This applies:
- To maintenance treatment
- To all ethnicities
- Regardless of dose strength
Once BMI falls below 22 kg/m², GLP-1 medication must usually be stopped.
This is a clinical and regulatory requirement, not a DoseDirect preference.
Why Is There a BMI Cut-Off for Mounjaro and Wegovy?
1. Evidence and Licensing Limits
GLP-1 medicines are licensed for adults living with overweight or obesity.
At lower BMIs:
- Clinical trial evidence is limited
- Metabolic risk is reduced
- Appetite suppression may become excessive
PGDs are deliberately conservative and evidence-led.
2. Patient Safety
Continuing appetite-suppressing medication at very low BMIs may increase the risk of:
- Excessive or unintended weight loss
- Nutritional deficiencies
- Lean muscle loss
- Hormonal disruption
- Disordered eating patterns
The BMI ≥ 22 kg/m² threshold acts as a safety boundary.
3. Regulatory Compliance
Patient Group Directions are legally binding clinical frameworks.
As a UK-registered pharmacy:
- We cannot prescribe outside PGD criteria
- We cannot override the BMI threshold
- The PGD is the final authority on eligibility
Is There a Maintenance Dose for Mounjaro or Wegovy?
Yes, but it varies between individuals.
A GLP-1 maintenance dose may involve:
- Staying at a mid-range dose
- Reducing to a lower dose
- Avoiding escalation once weight is stable
There is no requirement to reach the maximum licensed dose to remain on treatment.
Are There Any Exceptions to the BMI Cut-Off?
Only in very limited circumstances, such as:
- BMI remains marginally above 22 kg/m²
- Significant history of obesity-related disease
- Clear risk of rapid weight regain
However:
- Treatment below BMI 22 kg/m² is not routine
- Continuation is never guaranteed
- Each case is reviewed individually
What Happens When You Stop GLP-1 Medication?
Stopping GLP-1 treatment is not a failure.
As patients approach the BMI cut-off, we focus on:
- Planned dose reduction
- Managing appetite changes
- Supporting long-term weight stability
- Reinforcing sustainable habits without medication
The goal is to protect health gains, not to prolong treatment unnecessarily.
Transparency and Clinical Governance
All GLP-1 treatment at DoseDirect is:
- Supplied under UK-approved PGDs
- Clinically assessed by trained healthcare professionals
- Reviewed regularly for safety and effectiveness
- Aligned with national guidance and best practice
We do not offer:
- Automatic renewals without review
- Guaranteed long-term supply
- Treatment outside clinical boundaries
Key Takeaway
- GLP-1 maintenance is clinically recognised
- There is a BMI cut-off (≥ 22 kg/m²)
- The PGD governs all decisions
- Safety, evidence, and regulation always come first
Clinical Disclaimer
This content is for general information only and does not replace a personalised clinical assessment. All treatment decisions are made following consultation with a qualified healthcare professional.
