The flagship of the program

Here is exactly how we get you off it.

Not "when you're ready". Not "we'll see how it goes". A schedule, a set of things you can already do without the medication, and a clinician deciding each step with you.

Why most people regain

Two mechanical causes. Neither fixes itself.

Nine out of ten conversations about regain end up at one of these. Both have a clear answer if you start early.

Cause one

Muscle lost on the way down

Lose weight fast without enough protein or any resistance work and a real share of what leaves is muscle. You end up lighter with a slower engine. When eating returns to normal, the fat comes back first, and it comes back easily.

The fix is unglamorous: hit a protein floor daily, lift something twice a week, and do not chase the fastest possible loss.

Cause two

Nothing changed except appetite

If the medication did all the work, stopping it hands you back the same kitchen, the same schedule, the same 9pm. Appetite returns within weeks. It feels like relapse. It is just the drug leaving.

The fix is to spend the quiet months building meals, movement and routines you would keep even if nobody was prescribing anything.

The part other people leave out

Some patients do need medication long term, the way some people need a blood pressure tablet long term. That is a clinical decision made with your clinician, based on your health — not a mark against you, and not a failure of effort. We would rather say that out loud than sell you a finish line that might not be yours.

The four phases

What actually happens, month by month.

Phase one starts on day one. You do not wait until the end to think about the end.

Phase 1

Weeks 1–8

Build the floor

  • Hit your protein target four days out of five
  • Eat 30g of protein at breakfast, every day
  • Two short strength sessions a week, seated if needed
  • Walk after your largest meal
  • Baseline waist and body composition recorded

Phase 2

Months 3–6

Make it automatic

  • Protein target hit without thinking about it
  • Strength sessions progress in weight or reps
  • Three meals you can cook without a recipe
  • A plan for restaurants, work lunches and the 9pm problem
  • Waist re-measured monthly, not just weight

Phase 3

The step down

Find your lowest dose

  • One dose level down, reviewed by your clinician
  • Four weeks of holding before anything else changes
  • Hunger, energy and weight tracked weekly
  • Protein floor raised slightly during each step
  • Going back up a level is information, not failure

Phase 4

On your own

Maintenance that holds

  • Off medication, or on the lowest dose that is right for you
  • Monthly check-in with the care team
  • A written response for a 5-pound gain
  • Strength work continues — this is the insurance policy
  • The door stays open if you need to come back

The step down

What a dose reduction actually looks like

Six steps. Slow on purpose.

  1. 01

    You have to earn it, and it is easy to earn

    Protein target hit most days and strength work happening twice a week. That is the bar. Not a weight number.

  2. 02

    One level down, nothing else changes

    We change one variable at a time so we can read what happened. Same food plan, same training, lower dose.

  3. 03

    Four weeks of holding

    Hunger, energy, weight and waist tracked weekly. Most of what people fear shows up in week two and settles by week four.

  4. 04

    Your clinician reads the data with you

    Steady weight and manageable hunger means we hold or step again. Sharp hunger or fast regain means we stop and look.

  5. 05

    Going back up a level is information, not failure

    It tells us where your floor is. Plenty of people step down twice, go back once, and finish lower than they started.

  6. 06

    The last step is the smallest

    The gap between the lowest dose and nothing is where the habits carry it. If they are not there yet, we wait. Nobody is on a clock.

Written in advance

Your plan for the week hunger returns

It will happen. Deciding what you will do while it is happening is the worst time to decide. So we write it down first.

  • Protein first at every meal, before anything else on the plate
  • Three no-cook protein options already in the house
  • Two litres of water before you decide you are hungry
  • Keep the strength sessions even if the food week is messy
  • Message the care team by day three, not day thirty
  • Weigh weekly, not daily — one week is noise, four is a trend
A couple in their fifties walking together on a tree-lined path in late afternoon light
The habits that hold the result are ordinary ones

Questions

The ones people actually ask

Many patients do. Whether you are one of them depends on your health, how much muscle you kept, and how established the habits are. We will tell you honestly where you stand rather than promise a date.

A few pounds is normal fluctuation and we have a written response for it. A steady climb over four weeks means we look at protein, strength and sleep first, and reconsider dose with your clinician if those are solid.

Usually three to six months from the first step down, sometimes longer. Anyone offering a two-week taper is not paying attention.

Yes, and it is our lowest tier. Maintenance costs less than treatment because you need less of it. The pricing page lists exactly what is and is not included.

Message the care team the same week. Sudden change is worth a clinical look, and it is much easier to adjust early than to unwind a month of it.

Take the muscle protection check→

The plan for coming off starts on day one.

See where your muscle protection stands right now. It takes about a minute.

Muscle protection check→See pricing→