GLP-1 medications for weight management are FDA-approved for specific patient populations, and telehealth providers use these criteria to evaluate prescriptions. Here's who qualifies, and what happens if you're on the edge of the criteria.
Standard Qualification Criteria
FDA-approved GLP-1 medications for chronic weight management (Wegovy, Zepbound) are indicated for adults who meet one of these criteria:
- BMI ≥ 30 (obesity), or
- BMI ≥ 27 (overweight) with at least one weight-related comorbidity, such as:
- Type 2 diabetes
- High blood pressure (hypertension)
- High cholesterol (dyslipidemia)
- Obstructive sleep apnea
- Cardiovascular disease
These are the criteria from the FDA-approved label. Physicians have clinical discretion and may prescribe outside these criteria in specific circumstances, but these are the standard benchmarks.
Contraindications: Who Does Not Qualify
Certain conditions disqualify patients from GLP-1 medications regardless of BMI:
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple endocrine neoplasia syndrome type 2 (MEN 2)
- Prior serious hypersensitivity reaction to semaglutide or tirzepatide
- Pregnancy (or planning to become pregnant, discontinue 2 months before trying)
- Type 1 diabetes (GLP-1 medications are not approved for T1D)
Pancreatitis history is a relative contraindication, physicians evaluate case-by-case.
What If You're Below BMI 27?
GLP-1 medications for weight loss are not indicated for patients with BMI below 27. Telehealth providers will not prescribe to patients below this threshold. This isn't arbitrary, the clinical trials that established efficacy and safety enrolled patients with BMI ≥ 27 with comorbidities or BMI ≥ 30.
Type 2 Diabetes Consideration
If you have type 2 diabetes, GLP-1 medications (Ozempic for semaglutide, Mounjaro for tirzepatide) are FDA-approved for diabetes management at lower doses. Insurance coverage is more likely for this indication. Even without insurance, the weight loss benefits are the same, the active ingredient is identical.
The Telehealth Intake Process
Telehealth providers evaluate your qualification through a comprehensive intake form. Be accurate about your height, weight, and medical history. If you qualify based on BMI or comorbidities, a physician review determines whether any contraindications apply.