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What BMI Do You Need to Qualify for GLP-1 Medications?

Understanding eligibility criteria for semaglutide and tirzepatide—from FDA label requirements to how telehealth providers actually evaluate patients.

Updated: November 2025 7 min read

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

BMI ≥ 30

Patients with obesity qualify regardless of other health conditions

OR
BMI ≥ 27

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:

High blood pressure (hypertension)
Type 2 diabetes
Prediabetes
High cholesterol (dyslipidemia)
Sleep apnea
Cardiovascular disease
Non-alcoholic fatty liver disease
PCOS (in women)

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:

1.
Risk-benefit ratio: GLP-1 medications carry real risks (pancreatitis, gallbladder issues, possible thyroid concerns). These risks are justified when obesity itself poses significant health risks.
2.
Trial populations: The drugs were studied in people meeting these criteria. We have less safety and efficacy data for people outside these ranges.
3.
Clinical appropriateness: Weight loss medications are designed to treat obesity as a medical condition, not for cosmetic weight management.

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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