GLP-1 Eligibility: Do You Qualify for Weight-Loss Medication?

For weight management specifically, the two medications the FDA has approved are semaglutide (brand name Wegovy) and tirzepatide (brand name Zepbound). Their FDA-approved labels share the same core eligibility frame for adults:

• A BMI of 30 or higher (the clinical definition of obesity), or
• A BMI of 27 or higher (the overweight range) plus at least one weight-related health condition — the labels name examples such as type 2 diabetes, high blood pressure, and high cholesterol.

Both are approved as an addition to a reduced-calorie diet and increased physical activity, not as a standalone substitute for them. That framing matters: a careful provider treats the medication as one part of a plan, not a vending-machine product.

Two important distinctions people routinely miss. First, Ozempic and Mounjaro are not the same approvals as Wegovy and Zepbound. Ozempic (semaglutide) and Mounjaro (tirzepatide) are FDA-approved to improve blood sugar in adults with type 2 diabetes — they are frequently discussed for weight loss, but that is a different (off-label) conversation with different criteria. Second, in late 2024 the FDA also approved Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity, an indication separate from general weight management. A licensed provider decides which approval, if any, fits your situation.

BMI is weight in kilograms divided by height in meters squared. In pounds and inches, the formula is: (weight in lb ÷ height in inches²) × 703. A 5'6" adult weighing 186 lb has a BMI of roughly 30; the same person at 168 lb is around 27. The CDC's adult BMI categories are: under 18.5 (underweight), 18.5–24.9 (healthy weight), 25.0–29.9 (overweight), and 30.0 and above (obesity).

BMI is the gatekeeping number on virtually every GLP-1 screening form because it's the number the FDA labels use. But it's a population-level screening tool, not a complete picture of health. It doesn't distinguish muscle from fat and can misclassify very muscular people or, conversely, understate risk in others. That's exactly why the label allows a lower BMI threshold (27) when a weight-related condition is also present, and why a good clinician looks at the whole history rather than a single ratio. If your BMI sits right at a cutoff, an accurate, recently measured height and weight can change the answer — so it's worth measuring carefully rather than estimating.

The BMI-27 pathway only opens if you also have at least one weight-related health condition. The conditions explicitly named in the labels and most commonly accepted include:

• Type 2 diabetes
• High blood pressure (hypertension)
• High cholesterol or other dyslipidemia

Other weight-related conditions a clinician may consider, depending on the specifics and the medication, include obstructive sleep apnea, cardiovascular disease, and prediabetes. The key word is diagnosed: a condition you suspect you have but that has never been evaluated generally won't satisfy the criterion on its own. If you think you have an undiagnosed qualifying condition (for example, you've never had your blood pressure or A1c formally checked), getting that worked up through a primary-care visit can be a legitimate path to eligibility — and is worth doing for your health regardless of any medication decision.

A telehealth GLP-1 evaluation is a real clinical screening compressed into an online flow. While platforms differ, a responsible process generally includes:

1. Intake questionnaire. Height, weight (to compute BMI), age, weight history, current diagnoses, current medications and supplements, allergies, and personal and family medical history.
2. Safety screening. Direct questions about the contraindications below — thyroid cancer history, MEN 2, pancreatitis history, gallbladder disease, pregnancy or breastfeeding, and prior reactions to GLP-1 drugs.
3. Clinical review. A licensed provider reviews your answers. Some platforms require recent lab work or ask you to obtain labs; some offer asynchronous (message-based) review, others a live video or phone visit. Requirements vary by state law.
4. Prescribing decision. If the provider determines a GLP-1 is appropriate and you understand the risks, they may issue a prescription. If not, a legitimate service tells you no.

Platforms people use to get screened include Henry Meds, Ivim Health, ShedRx, Eden, MEDVi, TrimRx, Measured Health, Elevate Health, GobyMeds, Brello Health, and DrHouse, alongside broader telehealth names such as Ro, Hims & Hers, LifeMD, and PlushCare. For brand-name medication specifically, manufacturer-affiliated channels exist too: NovoCare (Novo Nordisk) and LillyDirect (Eli Lilly) connect patients to telehealth and pharmacy access for their own products. eMed and CareValidate operate in adjacent clinical-screening and verification roles. Naming a platform here is not an endorsement of your eligibility — only a licensed clinician who reviews your case can make that call.

Some medical histories make GLP-1 medications unsafe, and no telehealth flow should work around them. These are drawn from the FDA labels for semaglutide and tirzepatide:

• Boxed warning — thyroid C-cell tumors. In rodent studies, these drugs caused thyroid C-cell tumors. It's unknown whether they cause such tumors, including medullary thyroid carcinoma (MTC), in humans.
• Personal or family history of medullary thyroid carcinoma (MTC) — a contraindication.
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) — a contraindication.
• Prior serious hypersensitivity to the specific medication — a contraindication.

Beyond outright contraindications, the labels flag conditions that require caution or rule the drug out for many people, including a history of pancreatitis, gallbladder disease, diabetic retinopathy (for some patients), severe gastrointestinal disease, and kidney problems. Pregnancy and breastfeeding are also reasons these drugs are generally not used. This is not a complete list, and it's exactly the territory where a real clinical review earns its keep — the point of screening is to catch these before a prescription is written.

To keep expectations grounded in evidence rather than marketing: in the manufacturer's pivotal STEP 1 trial of semaglutide 2.4 mg, published in the New England Journal of Medicine in 2021, adults with obesity or overweight (without diabetes) on the medication plus lifestyle intervention had a mean change in body weight of about −14.9% over 68 weeks, versus about −2.4% in the placebo group. For tirzepatide, the SURMOUNT-1 trial (NEJM, 2022) reported mean weight reductions of roughly 15% to 21% across doses over 72 weeks versus about 3% with placebo. These are study findings in specific populations under trial conditions; they are not a prediction of what any individual will experience, and individual results vary.

The most commonly reported side effects in these trials were gastrointestinal — nausea, diarrhea, vomiting, and constipation — which were typically mild to moderate and often eased over time. Serious risks, including the boxed thyroid warning, pancreatitis, gallbladder problems, and low blood sugar (especially when combined with certain other diabetes medicines), are detailed in the labels. A licensed provider is the right person to weigh these against your situation.

You'll see much lower prices advertised for "compounded" semaglutide or tirzepatide. Two things to understand. First, compounded versions are not FDA-approved. The FDA does not review them for safety, effectiveness, or quality before they reach patients. Compounding expanded while the brand-name drugs were in shortage; as the FDA has resolved those shortages, the legal basis for widespread compounding has narrowed, and availability has shifted. Second, prices change constantly and vary by provider, dose, pharmacy, and whether insurance applies. Any figure you see — ours or a platform's — should be treated as a snapshot. Verify the current price, what's included, and whether it's a brand-name or compounded product directly at the source before you commit. If a price looks too good to be true and comes without any clinical consultation, treat that as a warning sign.

Falling outside standard criteria isn't the end of the conversation. Depending on why you didn't qualify, reasonable next steps include:

• If your BMI is close to a cutoff: re-measure your height and weight accurately. Small errors in either can move your BMI across a threshold. Don't manipulate numbers — a provider may verify them — but do make sure they're correct.
• If you're in the 27–29.9 range with no diagnosed comorbidity: see a primary-care clinician about whether you have an undiagnosed qualifying condition such as hypertension, prediabetes, or high cholesterol. This is good preventive care on its own.
• If you have a contraindication: respect it. Ask your clinician about non-GLP-1 approaches — other prescription weight-management medications exist, as do structured lifestyle, nutrition, and behavioral programs.
• If you're under 18: these adult criteria don't apply to you. Pediatric weight management is its own specialty; that conversation belongs with a pediatric clinician.

What none of these steps involve is sourcing prescription medication without a prescription, buying "research chemicals," or using grey-market suppliers. Those routes carry real safety and legal risks and fall entirely outside legitimate care.

Verifiable from primary sources: the BMI 30 / BMI 27-plus-comorbidity framework, the boxed thyroid warning, and the MTC/MEN 2 and hypersensitivity contraindications all come directly from the FDA-approved labels for Wegovy (semaglutide) and Zepbound (tirzepatide). The STEP 1 and SURMOUNT-1 efficacy figures come from peer-reviewed publications in the New England Journal of Medicine. CDC defines the adult BMI categories used above.

What we did not verify and you should confirm at the source: the exact intake, lab, and consultation requirements of each individual telehealth platform (these vary by company and by state and change over time); current pricing for any product, brand-name or compounded; and your own eligibility, which only a licensed clinician reviewing your full history can determine. We have not independently tested or vetted the clinical practices of the platforms named in this article; we list them because consumers use them, not as a judgment on whether they're right for you.