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Methods A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420261305875)

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Weight loss is known to trigger compensatory biology: Increased appetite signaling Reduced resting energy expenditure Heightened food reward sensitivity Stopping GLP-1 therapy at peak dose, without tapering and without reinforcing lifestyle strategies at the exact moment hunger returns, does not allow lifestyle behaviors to take over. Emerging real-world data and obesity physiology suggest a different, more clinically relevant path: Gradual dose reduction rather than abrupt cessation Continued, structured dietary and exercise support Active monitoring during the high-risk post-cessation period We still need randomized trials designed specifically to test tapering and lifestyle-anchored maintenance strategies

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