Reduced-Frequency GLP1 Therapy Maintains Weight, Body Composition, and Metabolic Syndrome Improvements: A Case Series.

Abstract

This study aimed to evaluate whether reduced-frequency dosing of GLP1 receptor agonists maintains weight loss, body composition, and metabolic syndrome improvements following successful initial treatment with standard weekly therapy. This retrospective case series included 30 adults who achieved weight plateau while on weekly semaglutide or tirzepatide. Patients transitioned to reduced-frequency dosing (usually every other week) at their existing dose. Data were collected at three time points: pre-treatment, plateau (weekly dosing), and maintenance (reduced-frequency dosing). Primary outcome was change in body weight from plateau to maintenance. Secondary outcomes included body composition and metabolic syndrome comorbidities. Patients maintained reduced-frequency dosing for an average of 36.3 weeks. Weight decreased from 87.9 ± 2.4 kg at pre-treatment to 74.1 ± 2.4 kg at plateau and further to 72.4 ± 2.2 kg on maintenance dosing (p < 0.01). Total body and truncal fat declined, while skeletal muscle mass stabilized on the reduced-frequency regimen. Metabolic parameters improved during weekly dosing and these gains were maintained during reduced-frequency therapy. In patients with prior weight loss and metabolic improvement on GLP1 therapy, reduced-frequency maintenance dosing preserved outcomes. These findings support structured de-escalation as a promising strategy to reduce treatment burden without sacrificing efficacy.