To get semaglutide for weight loss, you need a prescription from a licensed healthcare provider who confirms you meet specific weight criteria. You can get this prescription through your regular doctor, a weight management specialist, or one of several telehealth platforms that offer virtual consultations. The process typically involves a medical evaluation, bloodwork, and a gradual dose increase over several months.
Who Qualifies for a Prescription
The FDA approved semaglutide (sold as Wegovy) for weight loss in adults and adolescents 12 and older who have obesity, defined as a BMI of 30 or higher. Adults with a BMI between 27 and 29.9 also qualify if they have at least one weight-related health condition, such as high blood pressure or high cholesterol. These are the same thresholds most providers and insurance companies use to determine eligibility.
For reference, a BMI of 30 corresponds to roughly 210 pounds for someone who is 5’9″ or about 180 pounds at 5’4″. You can calculate yours with any online BMI tool, but your provider will confirm the number during your evaluation.
What Happens During the Medical Evaluation
Whether you visit a provider in person or through a telehealth platform, expect a similar process. Your provider will review your weight history, current medications, and any conditions that might make semaglutide unsafe for you. Most providers order bloodwork before or shortly after your first visit, commonly including thyroid function, a comprehensive metabolic panel, a lipid panel, an insulin resistance panel, and a kidney profile. These tests help rule out underlying conditions and give your provider a baseline to track your progress.
If everything checks out and you meet the BMI requirements, your provider can write a prescription. You’ll start at a low dose and increase gradually. The typical schedule begins at 0.25 mg once per week for the first four weeks, then increases to 0.5 mg at week five. From there, your provider may continue raising the dose based on how you respond and how well you tolerate the medication. The maintenance dose for weight loss with Wegovy is 2.4 mg per week, though it can take about 16 to 20 weeks of gradual increases to get there.
In-Person vs. Telehealth Options
Your primary care doctor or an obesity medicine specialist can prescribe semaglutide during a standard office visit. This is often the most straightforward route if you already have an established relationship with a provider and insurance coverage that includes weight management medications.
Telehealth platforms have become a popular alternative, especially for people who want a faster or more convenient process. Several platforms now offer semaglutide prescriptions through virtual consultations. The general workflow looks like this: you complete an online health questionnaire, get matched with a licensed provider, and schedule a video or asynchronous consultation. Some platforms, like Calibrate and LifeMD, require you to complete lab work at a local lab before your provider visit. Others, like PlushCare and Sesame Care, let you book directly with a board-certified provider who will assess your eligibility during the appointment. Noom Med pairs you with a provider after an initial quiz and may request labs before your visit.
Ro offers a streamlined model where you complete an online visit first, then a provider reviews your information and schedules a more in-depth follow-up. Regardless of the platform, a real licensed provider must evaluate you and write the prescription. No legitimate service will ship semaglutide without that step.
What It Costs
Cost is the biggest barrier for most people. The current list price for Wegovy is roughly $1,350 per month, though Novo Nordisk has announced it will lower the list price to $675 per month starting January 1, 2027, a reduction of about 50%. What you actually pay depends heavily on your insurance.
If your insurance covers Wegovy, the manufacturer offers a savings card that can reduce your copay to as little as $25 per month for a 28-day supply. This program is available to people with and without insurance, and you can find the savings card on the Wegovy website. Without any insurance or discount, you’ll pay closer to the full list price, which is why exploring every savings option matters.
Some telehealth platforms bundle their consultation fees with medication costs, while others charge separately for visits and prescriptions. Compare the total monthly cost, not just the consultation fee, when evaluating platforms.
Navigating Insurance Coverage
Even if your insurance plan covers weight loss medications on paper, most insurers require prior authorization before they’ll approve semaglutide. This means your provider submits documentation proving you meet specific clinical criteria, and the insurance company reviews it before agreeing to pay.
The exact requirements vary by insurer, but they commonly include documented BMI within the last 90 days (with current height and weight), evidence of weight-related health conditions, and confirmation that the prescriber has reviewed all contraindications. Some plans, particularly state Medicaid programs, set stricter thresholds. Maryland’s Medicaid program, for example, requires documented cardiovascular disease in addition to the BMI criteria, which is far more restrictive than the FDA label.
If your initial authorization is denied, your provider can often appeal. Many denials are overturned with additional documentation. Ask your provider’s office how they handle prior authorizations and appeals, because some are far more experienced with this process than others.
How Much Weight to Expect
In the landmark STEP 1 clinical trial, participants taking semaglutide 2.4 mg weekly lost an average of 14.9% of their body weight over 68 weeks, compared to 2.4% in the placebo group. For someone starting at 230 pounds, that translates to roughly 34 pounds over about 16 months. Individual results vary, and the weight loss is most effective when combined with a reduced-calorie diet and increased physical activity.
Weight loss tends to be gradual during the dose escalation phase and accelerates once you reach the maintenance dose. Most people see the majority of their results between months 4 and 12.
Common Side Effects
Gastrointestinal symptoms are the most frequent side effects. In clinical studies, about 31% of participants taking semaglutide experienced digestive issues like nausea, vomiting, diarrhea, or constipation, compared to roughly 13% of those taking a placebo. These symptoms are usually worst during dose increases and tend to improve as your body adjusts. The slow titration schedule exists specifically to minimize these effects.
Eating smaller meals, avoiding high-fat foods, and staying hydrated can help manage nausea. If side effects are severe, your provider may slow down the dose increases or hold at a lower dose for longer before moving up.
Avoid Compounded Versions
You may see compounded semaglutide advertised online at significantly lower prices. These products are made by compounding pharmacies rather than the original manufacturer, and the FDA has raised serious safety concerns about them. Some compounded versions use salt forms of the drug, such as semaglutide sodium or semaglutide acetate, which are chemically different from the active ingredient in approved products. The FDA has stated it has no information on whether these salt forms behave the same way in the body, and it is not aware of any lawful basis for using them in compounding.
Compounded drugs also skip the rigorous manufacturing and testing standards that FDA-approved medications must meet. The lower price is tempting, but you’re taking on unknown risks with an unverified product.