The Maintenance Problem
The STEP 4 trial proved the brutal truth: 67% of weight lost on semaglutide was regained within 1 year of discontinuation. GLP-1 receptor agonists suppress appetite and metabolic set-point defense only while active in the bloodstream.
Microdosing proposes a middle path: taking a fraction of the therapeutic dose (0.25-0.5mg semaglutide weekly, vs. the 2.4mg therapeutic max) to maintain appetite suppression without the expense and side-effect burden of full dosing.
Microdosing Protocols
Common maintenance microdose: 0.25-0.5 mg semaglutide per week (10-20% of max therapeutic dose). This maintains steady-state GLP-1 receptor activation sufficient to prevent appetite rebound while minimizing GI effects.
Some researchers alternate weeks (e.g., 0.5mg every other week) to reduce costs while maintaining partial receptor occupancy. The key is never dropping to zero abruptly—taper down over 4-8 weeks.