matt_MKE said:

Extending the interval and reducing the dose are pharmacologically different.

That is correct as far as it goes, and here is where it stops going. STEP 4 is the study that answers this and it is blunt. Participants who continued kept losing; participants switched to placebo regained about two thirds of what they had lost within a year, and the metabolic improvements faded with the weight. That is the same pattern as every other chronic-disease medication ever withdrawn, and it is an argument about the condition rather than about the drug.

matt_MKE said:

Extending the interval and reducing the dose are pharmacologically different.

The regain framing needs pushing back on. Two thirds regained means one third did not, and the trial provided no ongoing support to either group. Treating regain as pharmacologically inevitable is as unsupported as treating maintenance as automatic.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

This one has a reasonably settled answer, so here it is. One third of STEP 4 participants held most of their loss without the drug, and nobody has convincingly characterised who they are. That subgroup is the most interesting unanswered question in the field and it is routinely flattened into the two-thirds headline.

That is the short version; the long version is somebody else's post.

DataDave said:

STEP 4 is the study that answers this and it is blunt.

Can confirm. Same sequence, different timescale. I had assumed I was the exception until I read this.