Who qualifies for a GLP-1

The BMI rules on the labels

For chronic weight management in adults, the FDA labels for Zepbound, Wegovy and Saxenda use the same two paths:

• A BMI of 30 or higher, or
• A BMI of 27 or higher plus at least one weight-related condition, such as high blood pressure, type 2 diabetes or high cholesterol

Check your number with the BMI calculator.

BMI 27 and 30 by height

Weights are rounded to the nearest pound.

Other approved uses

• Wegovy is also approved to reduce the risk of heart attack, stroke and cardiovascular death in adults with established heart disease and obesity or overweight, based on the SELECT trial.
• Zepbound is also approved for moderate to severe obstructive sleep apnea in adults with obesity. See GLP-1s and sleep apnea.
• Ozempic, Mounjaro, Rybelsus, Trulicity and Victoza are approved for type 2 diabetes, not for weight management.

Labels change as new uses are approved. As of our last review, check DailyMed for the current indications.

Teens

Wegovy and Saxenda are approved for weight management in children 12 and older with obesity, defined using BMI percentiles for age and sex. Saxenda also has a minimum body weight on its label. Zepbound is approved for adults only.

Who should not take them

The labels list these contraindications:

• A personal or family history of medullary thyroid carcinoma
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• A serious allergic reaction to the drug or its ingredients

The labels also advise against use in pregnancy. See pregnancy and birth control.

What to bring to your appointment

Prescribers need the same details your insurer will ask for. Having them ready saves a second visit:

• A recent weight and height, or your BMI from the BMI calculator
• Your weight-related conditions and recent lab results, such as A1c, cholesterol and blood pressure readings
• Weight-loss approaches you've tried, with rough dates: diets, programs, apps, other medicines
• Your full medicine list, including supplements
• Family history of thyroid cancer or MEN 2
• Any history of pancreatitis, gallbladder disease, diabetic eye disease or severe stomach problems
• Pregnancy plans and your current birth control

Also bring your insurance card and, if possible, your plan's drug list. It helps your prescriber pick a drug your plan is more likely to cover.

Qualifying is not the same as coverage

Meeting the label criteria doesn't mean your insurance will pay. Many plans exclude weight-loss drugs or require prior authorization. Read the prior authorization guide and compare costs in the cost index.

When to call your doctor

• To discuss whether a GLP-1 fits your health history
• If anyone in your family has had thyroid cancer or MEN 2
• If you are pregnant, planning pregnancy or breastfeeding