The GLP-1 microdosing chart, with the evidence attached

People use the word for three different things. Tier 1: staying at a lower rung of the approved dose ladder instead of climbing to the maximum, which is ordinary clinical practice. Tier 2: taking the same dose at longer intervals, every 10 to 14 days or more instead of weekly, which has emerging case-series support but no randomized trial. Tier 3: true microdosing, meaning doses below the lowest approved amount, under 0.25mg semaglutide or 2.5mg tirzepatide, which is unstudied in trials and contested. Collapsing the three tiers into one word is where most confusion comes from.

More common than almost anyone assumes. A 2026 Evidation Health survey found 15% of injectable GLP-1 users reported microdosing, and a separate survey of more than 60,000 users found roughly 1 in 7 had tried it. The motivation split matters: about 41% do it to manage side effects and about a third to save money, which means the behavior does not disappear as prices fall.

The approved Zepbound and Mounjaro ladder runs 2.5, 5, 7.5, 10, 12.5, and 15mg weekly, and the label names 5, 10, and 15mg as maintenance doses. Anything under 2.5mg weekly is below-label territory that no randomized trial has studied. The interactive chart on this page shows the ladder, which zones each tier of microdosing refers to, and the evidence grade for each. It intentionally does not generate a personal dosing schedule, because that decision belongs with your prescriber.

For Wegovy, the label targets 2.4mg weekly but explicitly permits a permanent reduction to 1.7mg when the top dose is not tolerated. For Ozempic, 0.5mg and 1mg are both named maintenance doses. In practice many people hold whatever rung keeps appetite quiet and weight stable, which is a decision the label anticipates and prescribers make routinely. There is no single official maintenance dose after weight loss; the published literature describes lowest-effective-dose strategies rather than one number.

Unproven, but plausible at the first two tiers. A February 2026 case series in Obesity reported patients maintaining weight and metabolic markers on reduced and spaced doses, and concluded structured de-escalation is feasible in selected patients. No randomized trial has tested any de-escalation strategy against continuing or stopping. What is well established is the other direction: stopping abruptly without support led to about two-thirds of lost weight returning within a year in trial extensions. Anything between full dose and zero is currently a supervised judgment call.

Read the actual objections and a pattern appears: Cleveland Clinic says dose adjustments should happen through a physician familiar with your history, not via a syringe and an internet vial. Other obesity-medicine physicians make the same point about skipped medical oversight. The documented objection is to unsupervised dosing decisions and gray-market product, not to lower doses themselves, which the labels already permit in several forms. The practical takeaway: the difference between a maintenance strategy and a gamble is whether your prescriber knows and whether anything is tracking the result.

No. It maps what the word means, what the approved ladders look like, and what evidence exists at each tier, because that information is scattered and often sold dishonestly. It contains no dosing advice and no sourcing information. Every dose and interval decision belongs with your prescriber, and the most useful thing you can bring to that appointment is a clear record of your regimen, weight trend, and goals.