Wegovy is FDA-approved for adults with a BMI of 30 or higher, or a BMI of 27 or higher when at least one weight-related health condition is also present. For adolescents aged 12 and older, the threshold is a BMI at or above the 95th percentile for their age and sex. A separate indication also covers adults with established cardiovascular disease and a BMI of 27 or higher.
BMI Thresholds for Adults
The two main cutoffs are straightforward. If your BMI is 30 or above, that alone qualifies you for a Wegovy prescription for chronic weight management. A BMI of 30 is the clinical definition of obesity, so the drug is approved for anyone in that category regardless of other health conditions.
If your BMI falls between 27 and 29.9, you can still qualify, but you need at least one weight-related comorbidity. The conditions that typically count include high blood pressure, type 2 diabetes, high cholesterol, and obstructive sleep apnea. Your prescriber determines whether your specific condition meets the bar. Without one of these conditions, a BMI under 30 won’t meet the FDA-approved criteria.
The Cardiovascular Risk Indication
In addition to weight management, Wegovy carries a separate FDA approval to reduce the risk of major cardiovascular events like heart attack and stroke. This indication applies to adults aged 45 and older who have established cardiovascular disease (a prior heart attack, prior stroke, or peripheral arterial disease) along with a BMI of 27 or greater. Under this indication, the goal isn’t solely weight loss. It’s lowering the chance of another serious heart event.
BMI Requirements for Adolescents
Wegovy is approved for teens aged 12 and older, but the threshold works differently than for adults. Instead of a fixed number, the requirement is a BMI at or above the 95th percentile for the teen’s age and sex, which is the CDC’s definition of obesity in children. Because kids are still growing, what counts as the 95th percentile shifts with each birthday.
For a 12-year-old boy, that cutoff is a BMI of about 24.2. For a 12-year-old girl, it’s roughly 25.2. The numbers climb gradually with age. By 17, the threshold is around 28.2 for boys and 29.6 for girls. Your child’s pediatrician can plot their BMI on a growth chart to see exactly where they fall. There is no lower “overweight with comorbidity” pathway for adolescents the way there is for adults. Only obesity-level BMI qualifies.
How Wegovy Dosing Works
Regardless of which BMI category you fall into, everyone starts Wegovy the same way: a low dose that increases gradually over about four months. The schedule is designed to let your body adjust and reduce nausea and other gut-related side effects.
- Weeks 1 through 4: 0.25 mg once weekly
- Weeks 5 through 8: 0.5 mg once weekly
- Weeks 9 through 12: 1 mg once weekly
- Weeks 13 through 16: 1.7 mg once weekly
- Week 17 onward: 2.4 mg once weekly (maintenance dose)
Adults can stay at 1.7 mg for maintenance if they can’t tolerate the full 2.4 mg dose. Adolescents, however, are expected to reach the 2.4 mg maintenance dose. If side effects are an issue at any step, your prescriber may hold you at the current dose for an extra four weeks before moving up.
Who Should Not Take Wegovy
Meeting the BMI threshold doesn’t automatically mean Wegovy is safe for you. The drug carries a boxed warning, the FDA’s most serious safety label, related to thyroid cancer risk seen in animal studies. Anyone with a personal or family history of medullary thyroid cancer, or a rare inherited condition called multiple endocrine neoplasia syndrome type 2 (MEN2), should not use it.
Wegovy is also not appropriate if you’re using another semaglutide product (like Ozempic) or another GLP-1 receptor agonist, since doubling up increases risk without added benefit. Your prescriber will review your full medical history before writing a prescription.
What Insurance Typically Requires
Even if you meet the FDA criteria, your insurance plan may impose its own rules. Many commercial insurers and pharmacy benefit managers require prior authorization, meaning your doctor submits documentation of your BMI and any qualifying conditions before the claim is approved. Some plans add extra hurdles: proof that you’ve tried diet and exercise programs first, or that you’ve attempted other weight-loss medications. Medicare Part D plans have historically excluded coverage for weight-loss drugs, though that has started to shift for the cardiovascular indication.
If your insurance denies coverage, the out-of-pocket cost can be significant. It’s worth asking your prescriber’s office to handle the appeal, since many initial denials are overturned with proper documentation of medical necessity.