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Transitioning from weight loss to maintenance Determining goal weight achievement: Lost 10-12% body weight (cagrilintide alone) Lost 15-25% body weight (CagriSema) Weight stable for 4-8 weeks Satisfied with current weight Ready to focus on maintenance Maintenance dose options comparison: Option 1: Continue same dose Keep cagrilintide at 2.4mg weekly Ensures no regain Most conservative approach Highest cost Option 2: Reduce dose slightly Decrease to 1.8-2.0mg weekly Monitor weight for 4 weeks If stable, maintain If gaining, increase back 20-25% cost savings Option 3: Try every 10 days Instead of weekly, inject every 10 days Effectively 30% dose reduction Some maintain weight this way Requires close monitoring Recommendation: Try Option 2 first (reduce to 1.8-2.0mg)

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Lower calorie intake, mild dehydration, nausea affecting food and fluid tolerance, reduced protein consumption, sleep changes, and dose adjustments can all pull energy levels down at once

European Neurology, 23 (5), 358-363