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You hit your goal weight. So now what?

For a lot of people, maintenance feels like uncharted territory. And without the right mindset, it's easy to either white-knuckle it or slowly drift back to old patterns. 

In this episode, I walk through five things I think everyone needs to know about maintenance: why it's not a new phase, how to find the weight you can actually live at, how to monitor without judgment, what to do when your metabolism adapts, and what long-term GLP-1 use really looks like. 

• Maintenance Is Not a New Phase

Here's what I want you to understand from the start: maintenance is not a finish line. It's not a reward. It's just the next chapter of the same story.

This is the number one thing I see people get wrong. They reach their goal weight and immediately start looking for what they get to stop doing. The tracking, the mindful eating, the consistent movement. But maintenance should look almost identical to the weight loss phase. The only difference is that the scale isn't trending down anymore.

There's no return to "normal" eating. You don't graduate from your habits. What got you here is what keeps you here.  

• The Best Weight Is the One You Can Actually Live At

I don't care what the math says. If a number on the scale requires you to be miserable, rigid, and obsessive to maintain it, that's not your maintenance weight. That's a war with your body.

The best weight is the weight where you feel good, you're sustainable in your habits, and you're not constantly white-knuckling every meal. #

This is especially important for anyone considering next steps like skin removal surgery. I've had patients convinced they needed to lose another 20 pounds before seeing a surgeon, when their body composition already told a completely different story.

Work with your medical team to get the full picture. Don't chase a number that your body was never meant to live at. 

• Monitor Without Morality

Write that one down!

Most people do well with a maintenance range of about three to five pounds up and down rather than a single fixed number. Your weight will naturally fluctuate with hormones, travel, hydration, and stress. That's not failure, that's just being human.

What I recommend is simple: pick one day a month, put it in your calendar, and sit down to look at your trends. This way, you avoid the daily freak-out session and replace it with a calm monthly check-in.

If you notice you've been creeping up a pound or two each month for the past six months, that's useful data. That's your cue to make a small, early course correction before it becomes a bigger problem. 

• Metabolic Adaptation Is Real

This is the part nobody wants to hear, but it's important. You can do everything right and still see the scale start to creep up. Metabolism adapts over time and so the same behaviors eventually yield different results. That's not you failing. That's the nature of obesity as a chronic, relapsing condition.

If your doctor is shaming you or dismissing you when this happens, please find someone else. You deserve compassionate, informed care and you deserve a provider who understands that adjustment is part of the process (not proof that you did something wrong).

• If You're on a GLP-1, This Still Applies to You

GLP-1 medications are an incredible tool, but they don't change the rules of maintenance. The principles are exactly the same. Most people will stay on the same dose long-term, and regain is not inevitable if you continue doing the lifestyle work alongside the medication.

Think of it like blood pressure medication. You wouldn't stop taking it just because your numbers look good. Maintenance is ongoing treatment, not aftercare.

One More Thing: Maintenance Boredom Is Normal

You've spent months getting dopamine hits every time the scale went down. Now that it's stable and that rush is gone, it can feel strangely deflating. But that's totally normal. It actually means things are working.

The goal now is to find other ways to measure your progress and feel good about your life. Walk a 5K. Pick up a new hobby. Stop letting a number in a box be the main character of your story.

Boring is the promised land. We should all want boring!

Want to Go Deeper on Body Composition?

If you've heard me talk about body composition and want to actually understand what those numbers mean for you, I created a mini course just for that. It walks you through what body composition is, how it's measured, what to look for in a report, and how I use it clinically to help patients set realistic, meaningful goals.

It's a few short videos, comes with a PDF guide, and you get lifetime access, so you can revisit it whenever you need to. If your body composition report has ever felt like a foreign language, this is the course that finally translates it.

👉 Check out the Body Composition Mini Course here

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance.    

Maintenance Is Treatment, Not Aftercare

Rebecca, I promoted the body composition course here, can you make sure to promote it in the weekly email and in the blog post, and also can it makes it’s way into the carousel call to action? Maybe we have a different ManyChat word that gives them a link to register for that? Thanks.

Transcript:

 Welcome back to another episode of the podcast. How are you all doing? I am definitely starting to feel the longer days I'm feeling the energy go up. It's so incredible as we always start to head into the days getting back to being longer and the weather being better and things like that, that I always, I, I say this every year, I'm always like, oh, what was that during winter?

Today we're gonna talk about maintenance. This is something that a lot of you, when I've been asking here recently, Hey, what do you wanna hear episodes about? A lot of you. That this is what you wanted. By the way, I would always like to hear topics that you want to hear.

Below this, there's a thing that's called fan mail and you can click on that and send me a message reminder. It's anonymous. If you don't put an email, we can't get back to you I would love to hear if there are episodes that you wanna hear about. That way I really make sure to keep this podcast relevant.

I'm gonna go through about three to four, that's about four points of what I think is really important with maintenance. Keep in mind that it does not matter if you're on a GLP one or not, but I will make a comment if you're on one. Everyone always wants to know, does it stay the same? Does it go down?

I'll weave that in, but these concepts really, are broadly applicable. Number one, maintenance. It is not a new phase. It's the same life. Maintenance should look almost identical to when you are losing weight. The only difference is that the scale isn't trending down anymore. The thing that I think everybody's always looking for is this magical finish line when, oh, I've reached the promised land when the number is, whatever you decided arbitrarily.

But the problem is that you have to keep doing the same thing so there's no return to quote unquote normal eating. You don't get to graduate from habits. It's not like, and then I get to be much more liberal with everything. That's actually really not true. What you've been doing is likely what you need to keep doing to stay where you're at.

Now, if the scale keeps going down, that's an indication. All right. We either need to add in more calories more snacks or food to the meal, whatever it might look like, or we need to decrease the medication because you're too suppressed. But most people will naturally reach a maintenance weight and we will not have to adjust anything, and they stay right where they're at, if they're maintaining what they were doing on the way down.

The million dollar question is always, do you stay on the same dose or do you go down? And the problem is, it's unique for everyone. Most of my patients, because I work with people in my clinic that have a little bit more significant metabolic disease that they're dealing with, most of my people will stay on the same dose for maintenance.

Like what? They will stay on, what they were using prior. They'll stay on that for maintenance. There are some people where we might either decrease the dose or increase the length between injections, but those are people that usually continue to lose or that they're feeling too suppressed suddenly for some reason.

'Cause there's lots of things that can change in your life, but most of the people are staying the same. I will say that I am more a fan of decreasing dose than I am with increasing length because you can increase the length. I'm typically not going over a two week period. With that, it ends up being a little bit too much up and down for patients.

Let's take Tirzepatide as an example. It that's Zepbound Mounjjaro. It has a half life of five days. So you have to imagine if you're always taking out the seven day mark, you have a certain. Hill and valley and majority of the time where you're hanging out in the, as far as concentration. Okay?

Now, if you suddenly take that at the 14 day mark, you have had, instead of one half life occur, you have had multiple, every half life means half of it is broken down. I want you to imagine at the 14 day mark, you don't have very much left. You still have something, but it's very little compared to the amount that you had on the seven day mark when you took it again.

I see that if people are trying to do the two weeks, they'll end up losing the first one, two, the, like the first week, and then they'll gain the next week and then they lose and they lose and gain. And it's like, why are we doing that to you? I don't find that to be helpful. Okay.

Thing number two here, the best weight, it's gonna equal the weight that you can live at. The lowest weight does not equal the healthiest weight. If it requires you to be in misery, to be really rigid, to be obsessive with what you're doing, that's not maintenance. Body composition, math, it does not mean anything if it's not sustainable.

So I do not care, even if you're going through my body composition course and you're thinking yourself, you know different things, how would it apply to you? I don't care if the math quote unquote is great. If you can't maintain it, it's not realistic. Okay? I just really wanna stress that because people are so concerned, well, this number still needs to do X, Y, z.

I don't know, maybe it is or is not possible for your body. That's really where I would work with your medical team because it's very. Unrealistic often what people are wanting to get to versus what's successful. I have a lot of patients that will pursue skin removal surgery after they've lost a significant amount of weight and they're keeping it off, oftentimes they will always think I need to lose more before I can go to the plastic surgeon or whoever they're gonna go to get that consult from.

And I will look at. Body composition and go through all that kind of stuff, and I'll say, no, this is the right time. And all the time when they get to that surgeon and they'll say, oh yeah, this was the perfect time to come in. The patient still thought they had 10, 20 whatever to lose, but they were not factoring in skin, they were not looking at body fat composition, what's happening with skeletal muscle.

They were not taking all of it into account. They would've sat there and potentially tried to get themselves way lower when it's not where their body. Wants to live, should live is right for them. And so again, working with someone can really help with that. Body composition, again, that math, I don't care about it if it's unsustainable.

Alright? Thing number three, I want you to monitor without morality. I feel like everyone needs to write that down. This applies to everyone by the way. Not just maintenance

most people, I find it helpful if they have a maintenance range. Usually it's about three to five pounds up and down. And the reason I say this, you might actually be around the same number majority of the time, but if you're a woman, for example, and you're still having your periods, maybe the week before your period, you retain more fluid because of progesterone. It looks like you're gaining weight during that time. But that's really just hormonally based. And then. When your period is gone, that next week you return to where you were before. That's why having one number always need to be the case is just insanity, with travel, it will vary. I don't care how people do this, whether it's tracking weekly, monthly, I find a very helpful thing is to have a regular time. You're gonna evaluate the data, I actually don't care if you hop on the scale daily.

But don't be hopping on the scale daily. If every single day you judge yourself and you're always freaking out, then that's no longer helpful. Are you someone where it would be helpful to do a weekly weight and then once a month you sit down and look at it? Remember, we are always looking for patterns and trends.

I don't really care if one month you're up a few and then the next month you're down a few we wanna look over all what's happening. But what you will notice if you, once a month, the first of the month, I don't care what you do the first Sunday of the month, decide what you want it to be.

But if you once a month sit down and look at your data, you will see, oh, I have been putting on a pound or two per month for about the past six months. That means that there is something where I need to course correct in the opposite direction. Not a lot. It's literally like 20, 30 extra calories per day that's happening.

But there's something happening where I need to make a small adjustment, so I start to go back in the other direction. You're able to look at those trends instead of a single data point. It will radically change your life. Your course correction early means that it's not gonna be a crisis.

That's really important. Okay. Thing number four. Metabolic adaptation is real. You're doing the same behaviors, but eventually it can yield different results. Weight, regain. It can happen even when you're doing everything right.

I think this is really frustrating to people, and this is why this is such a hard disease long-term to manage because you really can still be doing all the things right and struggling. If your doctor is not believing that or is judging you, shaming you, please go find someone else like me that can help you to understand this and help you in a compassionate way.

That doesn't mean failure, it just means we need to adjust things. Realize just because you reach maintenance, it's not like cruise control. I never change anything again, you might not need to change things for 1, 2, 3 years, but I routinely see that people need to make some type of a change.

Within six months to a year. Something will have occurred it might not even be the weight going up, but they might be getting more hungry. There will be adjustments that are made, but that is not like you're doing something wrong. I just really wanna stress that. Okay number five here, GLP one Maintenance.

It is not fundamentally different. The principles are the same. The advantage is that you have more of that insulin resistance that's staying treated. You have more of that metabolic help, all the different ways in which it's working. I just mention insulin resistance because it's always at the top of my mind, but again, it's helping with all those things.

So regain is not inevitable, we see this based on years out with the studies that if you continue on it. That you can keep it off again, assuming that you're continuing to do all the lifestyle things that you were doing. Most people will need ongoing therapy, it's just like if it was hypertension.

Again, like we talked about in the first one up top, some might need a lower dose majority will stay where they're at. This is highly customizable where you really need to work with who you're seeing. I think if you really keep these things in mind number one, it's the same as any other phase.

Number two, the best weight is where you can actually live. You need to be really realistic with not. Putting rigid, obsessive things in place that you're not willing to stick with, and you will change over time what you're willing to do. Nowadays how long I walk, if I would've thought about that 10 years ago, I would've said That never can happen.

I shouldn't even start on this. I've changed over time who I am. At this moment, for example, if, if you told me, Mateo, you need to go strength train at a gym one hour, five days a week, I could not realistically make that work. If it was life or death, I could, but realistically, I would not wanna take that on right now.

So I will not do that as part of a routine thing if I know I can't stick with it. Little fits and spurts of doing crazy things is not what we're after, you're gonna monitor without judging yourself, without that morality aspect. And I would put it on the calendar, okay? Put on the calendar once a month.

Make it a recurring. Once a month, you can do that with Google Calendar. You say check weight trends or check, check metabolic health trends. Maybe take the word weight out of it. And you just, once a month, you're in the habit, Hey, this is the day. I just kinda look over everything

you're gonna keep in mind that these, with these metabolic adaptations, you might need to adjust things and that's not a problem. And then number five it's not like GLP ones are creating some type of magical village that's not existing for other people. It's an extra tool that you have in your toolkit, but you're still having to do all the work.

There's one other point that I wanna talk about, which is not like a main point, but something just a little thing that I want you to be cautious of, that I see maintenance, boredom is normal. Everybody repeat after me. Maintenance, boredom is normal. You are so used to getting dopamine hits with the scale going down, and you're constantly adding and doing new things and doing all that.

Now you need to create that dopamine hit in other ways. Now go walk a 5K, go hike a hill. Now go pick up some other hobbies. You cannot rely on the scale anymore. Now I'm hoping the whole darn time, you didn't rely on the scale, but if you did, because a lot of you it's is really human, that we're so defined by this box.

Okay? Or at least how society has conditioned us. Lemme put it that way, but it is normal to suddenly say, oh my gosh, what happens now? Okay. You need to now figure out other ways in which you're going to live your life. It's okay if there's a little bit of boredom.

There's not novelty, nothing new. That is the promised land where things are boring. We all want to achieve boring. Last thing will be this. If you have some regains that does not equal relapse. That does not mean that everything is lost. That does not mean a failure that is actually just part of the natural ebb and flow of obesity.

It is a relapsing, remitting condition means that you're gonna have times when it shows up. You're gonna have times where you're doing great. If you cannot let that define you and just do some course corrections or check in with your medical team, you just treat this like any other data when we stop taking it on personally.

The results are so much better. It's data. It's not a character flaw. Alright, I hope that these things are helpful for you. If you're someone that you want to learn more about body composition, 'cause you hear me talk about it here, where I'm like, even if you can't achieve those numbers, if you're someone that you wanna learn.

What practically should I be looking for in a body composition report? What are some things I could be thinking about? I have made just a little mini course on that where I take you through what is body composition, what are some of the common ways that it's done? What about the home options? I don't talk about every home option, but I too talk about several, and I talk about the aspect that is unique about this course that I don't see being done out there.

I talk about some examples. That I see clinically and what is helpful in those scenarios. There's no medical advice, but you get that educational picture that is very hard to see that because you're not really in the office with an obesity medicine doctor all the time, so if you're wanting to see, okay, realistically here are some goals that I could try to word or why it makes sense really for you, how to look at things and you wanna learn, oh, in this scenario, she tried that and that that was her reasoning.

And here she tried that. That would be the course for you. I will have the link for that down below. And also this is one where you have access to it for life. It's a few videos and of course there's always a PDF that goes with it so you can follow the information.

This is something where you can come back to it at any point that's not, or you have to get through it quickly or anything like that, because I know this is one of those things where you are gonna do it. You're gonna get through it real quick, you're gonna blast it, you're gonna figure things out, and then you're probably gonna come back to it maybe two, three months later, six months later, and you're gonna just revisit it.

If anything changes my thoughts on the area, I will update the video. I do this once a year. I look through all my courses, even my. Five mistakes that people make on a GLP one. I recently re-listened to everything and I wouldn't change how I talk about those things. So the videos remain the same.

One of the problems with body composition and stuff like that you learn more over time. You, I change philosophies or my thoughts. That's, you should have a clinician that's doing that. So if things change, I will update that course. So again, you have that for life.

If I ever change things there. It'll just get automatically updated. I usually send out an email if there's, a video has been added to the core site or something's been changed.

I usually give you that heads up. All right. That's what I have for you today. I hope you all have an amazing rest of the week and we'll talk soon.