GLP-1 Prescription Requirements: Who Qualifies in 2026?
Complete guide to GLP-1 prescription requirements: BMI thresholds, qualifying conditions, contraindications, and how to check eligibility online.
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Quick answer: Who qualifies for a GLP-1 prescription?
To qualify for a GLP-1 prescription in the United States, you must have a BMI of 30 or higher (obesity), or a BMI of 27 or higher (overweight) with at least one weight-related condition such as high blood pressure, type 2 diabetes, high cholesterol, or sleep apnea. You must be 18 or older and not have a history of medullary thyroid carcinoma, MEN 2, pancreatitis, or severe gastrointestinal disease.
To check if you qualify, complete an online eligibility assessment or use our GLP-1 eligibility calculator.
GLP-1 prescription eligibility criteria
The FDA has established specific criteria for GLP-1 weight loss medications. These criteria apply to all GLP-1 medications prescribed for weight management, including Wegovy (semaglutide), Zepbound (tirzepatide), and Saxenda (liraglutide).
BMI requirements
| Category | BMI | Qualifies? | Additional Requirements |
|---|---|---|---|
| Obesity | ≥ 30 | Yes | None |
| Overweight + comorbidity | 27–29.9 | Yes | At least 1 weight-related condition |
| Overweight, no comorbidity | 27–29.9 | No | Does not meet FDA criteria |
| Normal weight | < 27 | No | Does not meet FDA criteria |
Calculate your BMI using our BMI calculator.
Qualifying weight-related conditions
If your BMI is between 27 and 30, you need at least one of the following conditions to qualify:
- High blood pressure (hypertension) — systolic ≥ 130 or diastolic ≥ 80, or on blood pressure medication
- Type 2 diabetes — HbA1c ≥ 6.5%, or on diabetes medication
- High cholesterol (dyslipidemia) — elevated LDL, low HDL, or on lipid-lowering medication
- Obstructive sleep apnea — diagnosed or symptomatic (loud snoring, daytime sleepiness)
- Cardiovascular disease risk factors — family history, smoking, or other risk factors
Who should NOT take GLP-1 medications (contraindications)
The following are absolute or relative contraindications for GLP-1 medications:
- Medullary thyroid carcinoma (MTC) — personal or family history. GLP-1 medications carry a boxed warning for thyroid C-cell tumors.
- MEN 2 syndrome — Multiple Endocrine Neoplasia type 2.
- Pregnancy — GLP-1 medications should be stopped at least 2 months before planned pregnancy.
- Breastfeeding — it is not known if GLP-1 medications pass into breast milk.
- Pancreatitis — history of acute or chronic pancreatitis.
- Severe gastrointestinal disease — including gastroparesis, as GLP-1s slow gastric emptying further.
- Known hypersensitivity — allergy to semaglutide, tirzepatide, or formulation ingredients.
Conditions that require caution (not absolute contraindications)
- Hypothyroidism / Hashimoto's — not contraindicated, but disclose to your provider. See our GLP-1 and Hashimoto's guide.
- Diabetic retinopathy — GLP-1s may worsen retinopathy in some patients; consult your eye doctor.
- Gallbladder disease — GLP-1s increase risk of gallstones. See our GLP-1 and gallbladder guide.
- Kidney disease — GLP-1s may affect kidney function, particularly with dehydration from GI side effects.
- Depression or anxiety — the FDA is investigating a potential link between GLP-1s and mood changes. See our GLP-1 and mental health guide.
Not sure if you qualify?
A licensed provider can review your medical history and determine eligibility
Check my eligibilityWhat information do you need for the prescription process?
When completing an online medical intake for a GLP-1 prescription, you will need:
- Current height and weight (to calculate BMI)
- Medical history, including chronic conditions and surgeries
- Current medications and supplements
- Allergies and adverse drug reactions
- Family medical history (especially thyroid cancer, pancreatic disease)
- Recent lab results (if available) — HbA1c, lipid panel, metabolic panel
- Blood pressure readings (if known)
- Weight loss history and previous attempts
How providers determine the right GLP-1 medication
A licensed healthcare provider will consider several factors when choosing the right GLP-1 medication for you:
- Weight loss goals — tirzepatide produces greater weight loss than semaglutide
- Budget and insurance — compounded options are cheaper; brand-name options may be covered by insurance
- Medical history — certain conditions may make one medication preferable over another
- Side effect tolerance — tirzepatide may cause fewer GI side effects than semaglutide in some patients
- Route preference — oral semaglutide is available for those who prefer pills over injections
- Comorbidities — cardiovascular disease may favor semaglutide (SELECT trial data); sleep apnea may favor tirzepatide (Zepbound is FDA-approved for OSA)
For a full comparison of GLP-1 medications, see our GLP-1 comparison guide and best GLP-1 for weight loss guide.
FAQ
What BMI do you need for a GLP-1 prescription?
BMI ≥ 30 (obesity), or BMI ≥ 27 (overweight) with at least one weight-related condition like high blood pressure, type 2 diabetes, high cholesterol, or sleep apnea.
What conditions qualify you for a GLP-1 prescription?
Qualifying conditions include high blood pressure, type 2 diabetes, high cholesterol, obstructive sleep apnea, and cardiovascular disease risk factors. You need at least one if your BMI is 27–29.9.
Can you get a GLP-1 prescription without diabetes?
Yes. Wegovy and Zepbound are FDA-approved for weight management regardless of diabetes status.
What disqualifies you from getting a GLP-1 prescription?
History of medullary thyroid carcinoma, MEN 2 syndrome, pancreatitis, severe GI disease, or pregnancy/breastfeeding.
Do you need lab tests before getting prescribed?
Some providers may request recent labs (HbA1c, lipid panel), but many telehealth providers can prescribe based on medical history and self-reported measurements.
Can I get a GLP-1 prescription if I have hypothyroidism?
Yes. Hypothyroidism (including Hashimoto's) is not a contraindication. The specific contraindication is medullary thyroid carcinoma and MEN 2.
What age do you need to be?
18 or older for adult prescriptions. Wegovy is also approved for adolescents 12+ with obesity, but this requires a pediatric specialist.
How do I check if I qualify?
Calculate your BMI and review your weight-related conditions. Use an online eligibility calculator or complete a telehealth medical intake for a provider assessment.
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