GLP-1 medications aren't approved for everyone who wants to lose a few pounds. The FDA established specific BMI criteria for weight loss indications—but telehealth providers may have their own requirements. Here's what you need to know about qualifying.
FDA-Approved BMI Requirements
For FDA-approved weight loss medications like Wegovy (semaglutide) and Zepbound (tirzepatide), the labeling specifies who should receive these medications:
Standard Eligibility Criteria
Patients with obesity qualify regardless of other health conditions
Patients who are overweight AND have at least one weight-related health condition
What Counts as a Weight-Related Condition?
For patients with a BMI between 27-29.9, qualifying comorbidities typically include:
Calculate Your BMI
BMI (Body Mass Index) is calculated using your height and weight. Use this quick reference:
BMI Formula
BMI = Weight (lbs) ÷ Height (inches)² × 703
Example: A person who is 5'8" (68 inches) and weighs 200 lbs:
200 ÷ (68 × 68) × 703 = 30.4 BMI
| BMI Range | Classification | GLP-1 Eligible? |
|---|---|---|
| Below 18.5 | Underweight | No |
| 18.5 – 24.9 | Normal weight | No |
| 25.0 – 26.9 | Overweight | No |
| 27.0 – 29.9 | Overweight | With comorbidity |
| 30.0 – 34.9 | Class I Obesity | Yes |
| 35.0 – 39.9 | Class II Obesity | Yes |
| 40.0+ | Class III Obesity | Yes |
How Telehealth Providers Evaluate Eligibility
Most legitimate telehealth providers follow the FDA-approved criteria when prescribing GLP-1 medications. During your consultation, they'll typically ask about:
- • Current weight and height (to calculate BMI)
- • Medical history including weight-related conditions
- • Current medications
- • Previous weight loss attempts
- • Contraindications (thyroid cancer history, MEN2, pancreatitis, etc.)
Beware of No-Questions-Asked Providers
If a provider prescribes GLP-1 medications without any medical evaluation—or to people who clearly don't meet eligibility criteria—that's a red flag. Legitimate prescribers evaluate each patient's medical suitability, not just their willingness to pay.
Do Compounded Providers Have Different Requirements?
Compounded medications are prescribed off-label by definition (they're not FDA-approved products). This gives providers more flexibility in prescribing criteria—but responsible providers still follow similar eligibility guidelines.
That said, you may find that some compounded GLP-1 providers:
More flexible on documentation
May accept self-reported weight and conditions without requiring lab work
Consider lower BMI ranges
Some may prescribe for BMI 25+ with provider discretion
Broader interpretation of comorbidities
May include conditions like joint pain or low energy related to weight
Why BMI Requirements Exist
These eligibility criteria aren't arbitrary—they're based on the clinical trials that led to FDA approval:
What If You Don't Qualify?
If your BMI is below 27 (or 27-30 without comorbidities), legitimate providers shouldn't prescribe GLP-1 medications. Instead, consider:
- • Diet and exercise programs — the foundation of healthy weight management
- • Working with a registered dietitian — personalized nutrition guidance
- • Behavioral counseling — addressing habits and relationship with food
- • Medical evaluation — checking for underlying conditions affecting weight
Seeking GLP-1 medications when you don't meet eligibility criteria puts you at risk of unnecessary side effects and may indicate a provider prioritizing revenue over appropriate medical care.
Quick Qualification Checklist
You likely qualify if:
- ☐ Your BMI is 30 or higher
- — OR —
- ☐ Your BMI is 27-29.9 AND you have high blood pressure
- ☐ Your BMI is 27-29.9 AND you have type 2 diabetes or prediabetes
- ☐ Your BMI is 27-29.9 AND you have high cholesterol
- ☐ Your BMI is 27-29.9 AND you have sleep apnea
You should NOT take GLP-1s if:
- ✗ You have a history of medullary thyroid cancer or MEN2
- ✗ You have a history of severe pancreatitis
- ✗ You are pregnant or planning to become pregnant
- ✗ You are allergic to semaglutide or tirzepatide
The Bottom Line
The standard requirement for GLP-1 weight loss medications is BMI ≥ 30, or BMI ≥ 27 with a qualifying weight-related health condition. These criteria exist because the benefits of GLP-1 treatment outweigh the risks primarily for people in these categories. A legitimate provider should evaluate your eligibility based on your medical situation—not just take your money without proper assessment.
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