To qualify for a GLP-1 medication, you generally need either a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related health condition such as high blood pressure, type 2 diabetes, or high cholesterol. These are the FDA-approved thresholds, and they apply whether you’re getting a prescription through your primary care doctor, an endocrinologist, or a telehealth platform. The specific requirements can shift depending on whether the drug is prescribed for weight loss or diabetes, whether you’re going through insurance, and your medical history.
BMI Thresholds for Weight Loss Prescriptions
The FDA uses two BMI cutoffs for GLP-1 drugs approved for chronic weight management (brands like Wegovy and Zepbound). If your BMI is 30 or above, you meet the obesity threshold and can qualify based on weight alone. If your BMI falls between 27 and 29.9, you qualify only if you also have at least one weight-related comorbidity.
The conditions that count at the lower BMI threshold include:
- Type 2 diabetes or prediabetes
- High blood pressure
- High cholesterol or high triglycerides
- Cardiovascular disease
- Obstructive sleep apnea
These aren’t obscure conditions. The majority of adults with a BMI over 27 have at least one of them, which is why many people in the “overweight” category still qualify. Your doctor will typically check your blood pressure, order basic blood work, and review your health history to document the comorbidity. All GLP-1 weight loss drugs are approved as an add-on to a reduced-calorie diet and increased physical activity, not as a standalone treatment.
Qualifying for Type 2 Diabetes
GLP-1 medications were originally developed for blood sugar control, and several are FDA-approved specifically for type 2 diabetes rather than weight loss. Ozempic (semaglutide) and Mounjaro (tirzepatide) are the most well-known diabetes versions. If you have a type 2 diabetes diagnosis, you can qualify for these drugs regardless of your BMI. The prescribing decision is based on your blood sugar management and overall treatment plan.
This distinction matters because insurance coverage often differs between the diabetes and weight loss indications. The same active ingredient may be covered under one brand name (for diabetes) but denied under another (for weight loss). Your doctor may prescribe the diabetes-indicated version if you have both conditions, since it’s more likely to be approved by your insurer.
Who Cannot Take GLP-1 Medications
Certain medical conditions disqualify you from GLP-1 therapy entirely. The most important contraindication is a personal or family history of medullary thyroid carcinoma, a rare type of thyroid cancer. You also cannot take these drugs if you have Multiple Endocrine Neoplasia type 2 (MEN2), a genetic syndrome that raises the risk of certain tumors. These restrictions are listed on every FDA-approved GLP-1 label.
A history of pancreatitis, severe gastrointestinal disease, or a prior allergic reaction to any GLP-1 ingredient will also factor into your doctor’s decision. Pregnancy is another clear exclusion. During your evaluation, expect your provider to ask detailed questions about your thyroid history and family cancer history before writing a prescription.
Qualifying as a Teen
Some GLP-1 medications are approved for adolescents. Saxenda (liraglutide) is approved for patients aged 12 and older who are obese, defined by age- and sex-specific BMI cutoffs that correspond to a BMI of 30 or higher in adults. The teen must also weigh more than 132 pounds (60 kg). Wegovy has a similar pediatric approval. The FDA based these decisions on clinical trials in adolescents, including a 56-week study of 251 patients aged 12 to 17. Pediatric prescriptions typically require a pediatric endocrinologist or obesity specialist rather than a general practitioner.
What Insurance Companies Require
Meeting the FDA criteria doesn’t automatically mean your insurance will cover the medication. Most plans add their own layers of requirements before approving a GLP-1 prescription, and the process can take weeks.
Prior authorization is nearly universal. Your prescriber submits documentation to your insurer proving you meet the clinical criteria. Beyond that, many plans require step therapy, meaning you must show that you tried and failed cheaper treatments first. This could mean documenting months on a different weight loss medication or a supervised diet program that didn’t produce results. Some insurers also require documentation of participation in a structured weight management program, a record of your weight history over time, and evidence of regular follow-up visits.
If your initial request is denied, you can appeal. Your doctor’s office can often handle the appeal by providing additional clinical documentation. The specific requirements vary widely between plans, so calling your insurer before your first appointment saves time. Ask specifically whether GLP-1 medications are on the formulary, what prior authorization steps are needed, and whether step therapy applies.
The Telehealth Qualification Process
Telehealth platforms have become a common route to GLP-1 prescriptions, and their qualification process mirrors what you’d experience in person. You’ll fill out a detailed intake form covering your medical history, current medications, previous weight loss attempts, and any metabolic or cardiovascular conditions. Most platforms then schedule a video consultation where a provider reviews your information, discusses your health goals, and determines whether you’re an appropriate candidate.
You’ll need to provide your height, weight, and often recent blood work or lab results. Some platforms accept self-reported measurements, while others require verification from a recent doctor’s visit. If you don’t have recent labs, the provider may order blood work before finalizing the prescription. Reputable platforms will decline to prescribe if you don’t meet the clinical criteria or have a contraindication, so be thorough and honest during the intake process.
Supply and Access Considerations
Even after qualifying, you may face practical hurdles filling your prescription. GLP-1 medications have been in shortage since 2022 due to surging demand. As of early 2025, the FDA has determined that both semaglutide and tirzepatide injection shortages are officially resolved, though intermittent localized supply disruptions may still occur as products move through the distribution chain from manufacturers to local pharmacies.
During the shortage period, compounding pharmacies produced custom versions of these drugs. The FDA allowed this temporarily but has been winding down that enforcement discretion as brand-name supply stabilizes. Some other GLP-1 products, including dulaglutide and liraglutide injections, still have limited availability as of early 2025. If your pharmacy can’t fill your prescription immediately, ask about alternative locations or whether your provider can prescribe a different GLP-1 that’s in stock.