Getting a weight loss shot starts with a medical evaluation to determine if you qualify, followed by a prescription from a licensed provider. Three injectable medications are currently FDA-approved for long-term weight management: Wegovy (semaglutide), Zepbound (tirzepatide), and Saxenda (liraglutide). All three require a prescription, and most providers will check your BMI, health history, and bloodwork before writing one.
Who Qualifies for a Weight Loss Shot
Weight loss injections are approved for adults with a body mass index (BMI) of 30 or higher. You can also qualify with a BMI of 27 or higher if you have at least one weight-related health condition, such as type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, cardiovascular disease, or a form of liver inflammation called MASH.
These aren’t cosmetic medications. The BMI thresholds exist because the drugs were studied in people at those weight levels, and the benefits need to outweigh potential side effects. If your BMI falls below 27 with no related conditions, you’re unlikely to get a legitimate prescription.
What Happens at the Medical Evaluation
Your provider will start with a basic health assessment. This typically includes bloodwork to check kidney function, liver function, thyroid markers, blood sugar, cholesterol levels, and a complete blood count. These tests confirm your body can safely process the medication and establish baseline numbers to track your progress. Pancreatic and thyroid function get special attention because of rare but serious side effects like pancreatitis or thyroid disorders.
Your doctor will also review your medical history for conditions that might rule out these medications, such as a personal or family history of a type of thyroid cancer called medullary thyroid carcinoma. If everything checks out, you’ll get a prescription and instructions for self-injection at home.
Where to Get a Prescription
You have two main routes: your primary care doctor (or a weight management specialist) and telehealth platforms. Both can prescribe the same medications, but the experience differs.
In-person visits offer face-to-face accountability, hands-on guidance for your first injection, and the ability to do bloodwork on-site. The downsides are higher costs from facility fees, set appointment times, and geographic limitations if you don’t live near a specialist.
Online weight loss clinics have grown rapidly. They’re typically more convenient, lower cost, and let you manage the process from home with digital tools and virtual check-ins. A Mayo Clinic study found that participants in an online program lost an average of 5.3% of their body weight at six months, compared to 2.9% in a similar in-person program. The trade-off is less hands-on support and dependence on reliable internet access. Some telehealth platforms require you to get lab work done separately at a local clinic before they’ll prescribe.
Regardless of the route, the prescriber should be a clinician experienced in weight management or diabetes care. Be cautious of providers who skip the medical evaluation or bloodwork entirely.
How the Dosing Schedule Works
Weight loss shots aren’t prescribed at full strength from day one. The dose increases gradually over several weeks to give your digestive system time to adjust and reduce side effects like nausea.
For Wegovy, you start with a small weekly injection and increase the dose every four weeks across five steps, reaching the full maintenance dose after about four to five months. Zepbound follows a similar pattern, starting low and increasing by a set amount every four weeks until you reach an effective dose, which can vary from person to person. Saxenda uses daily injections with a shorter ramp-up period.
Your provider will check your progress after the first couple of months. If there’s no meaningful weight change after about eight weeks, they may discontinue the medication. Similarly, if side effects like nausea and diarrhea persist beyond four to six weeks, the medication may not be the right fit for you.
Insurance Coverage and Out-of-Pocket Costs
Insurance coverage for weight loss shots is inconsistent and often frustrating. Many plans require prior authorization, meaning your doctor must submit documentation proving you meet specific criteria before the insurer agrees to pay. Some insurers cover these medications only for certain diagnoses (like type 2 diabetes or sleep apnea) but not for weight loss alone. Medicare currently does not cover weight loss drugs for most indications, though this is evolving.
Without insurance, these medications are expensive. List prices for Wegovy and Zepbound run roughly $1,000 to $1,300 per month, though manufacturer savings programs and pharmacy discount cards can reduce that for some patients. If cost is a barrier, ask your provider about available savings programs directly from the drug manufacturers.
Compounded Versions: What to Know
You may have seen lower-cost versions of semaglutide or tirzepatide offered through med spas, wellness centers, or online pharmacies. These are compounded medications, mixed by specialty pharmacies rather than manufactured by the original drug companies. Compounded drugs are not FDA-approved and do not go through the same review process for safety, effectiveness, and quality.
During drug shortages, compounding pharmacies were legally permitted to produce versions of these medications. That window has narrowed. Neither semaglutide nor tirzepatide currently appears on the FDA’s drug shortage list, which restricts the conditions under which they can legally be compounded. The FDA has warned that compounded versions pose a higher risk to patients and has taken enforcement action against products found to be substandard or unsafe.
Counterfeit products are also a concern. They’re often sold online, through social media, or at wellness centers. If you’re prescribed a brand-name medication, fill it at a licensed pharmacy. Eli Lilly, the maker of Zepbound, offers a verification tool at scan.lilly.com where you can check whether your product is authentic.
What to Expect After You Start
The injections are self-administered at home using a prefilled pen, similar to an insulin pen. You inject once weekly (for Wegovy or Zepbound) into your abdomen, thigh, or upper arm, rotating the injection site each time. Most people find the process straightforward after the first one.
Common side effects during the dose ramp-up period include nausea, diarrhea, constipation, and reduced appetite. These tend to be strongest in the first few weeks at each new dose level and often improve as your body adjusts. Your provider will monitor your blood sugar and electrolyte levels periodically to catch any issues early.
These medications are designed for long-term use. Research consistently shows that weight regain is common after stopping, because the drugs work by mimicking gut hormones that regulate appetite. When the medication stops, that appetite suppression goes away. This is something worth discussing with your provider upfront so you have realistic expectations about what long-term treatment looks like.