Before you compare providers or pricing, there is a more basic question: will anyone actually prescribe this to you? Eligibility for GLP-1 weight loss medication comes down to three things — your BMI, your medical history, and the prescribing rules the individual provider follows. This guide explains all three in plain language.
The Quick Answer
Standard eligibility for weight management
- BMI of 30 or higher (clinical obesity), or
- BMI of 27 or higher plus at least one weight-related health condition
- Adult (18+) for most telehealth providers
- No disqualifying medical history — see the contraindications section below
These thresholds mirror the FDA-approved labeling for the brand-name weight management drugs (Wegovy and Zepbound). Most telehealth providers apply the same criteria whether they dispense brand-name or compounded medication.
If you do not meet these numbers, that is not automatically the end of the conversation — but it does mean a legitimate provider should be asking follow-up questions rather than approving you instantly. A service that prescribes without checking any of this is a red flag, not a convenience.
BMI Criteria Explained
BMI (body mass index) is calculated from your height and weight. It is an imperfect measure — it does not distinguish muscle from fat — but it is the standard screening tool prescribers use, so it is worth knowing your number before you apply.
How BMI is calculated
BMI = weight (lb) ÷ height (in)² × 703
Example: someone 5'6" (66 in) weighing 190 lb has a BMI of about 30.7 — above the 30 threshold, so they would generally qualify on BMI alone.
Rough weight thresholds by height
These are approximate weights at which BMI reaches 27 and 30. Use them as a sanity check, not a diagnosis.
| Height | BMI 27 (~) | BMI 30 (~) |
|---|---|---|
| 5'0" | 138 lb | 153 lb |
| 5'4" | 157 lb | 175 lb |
| 5'8" | 177 lb | 197 lb |
| 6'0" | 199 lb | 221 lb |
| 6'2" | 210 lb | 233 lb |
Most telehealth intake forms calculate BMI for you from the height and weight you enter. Be accurate. Inflating your weight to clear a threshold means a clinician is making decisions about your care using false information, and it can affect dosing.
Weight-Related Conditions That Count
If your BMI is between 27 and 30, you generally need at least one weight-related condition to qualify. The conditions prescribers most commonly accept include:
- Type 2 diabetes or prediabetes
- High blood pressure (hypertension)
- High cholesterol or dyslipidemia
- Obstructive sleep apnea
- Cardiovascular disease
- Non-alcoholic fatty liver disease
- Polycystic ovary syndrome (PCOS)
- Osteoarthritis related to weight
You will usually be asked to self-report these on the intake form. Some providers will ask for documentation or a recent lab result; others accept your answer at face value. If you have a diagnosis in your chart, have the details handy — the condition name, roughly when you were diagnosed, and any medications you take for it.
Who Should Not Take a GLP-1
Some medical histories rule out GLP-1 medication entirely, and some call for caution and closer monitoring. This is the part of the intake form you should never fudge.
Absolute contraindications (do not take)
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known hypersensitivity to semaglutide, tirzepatide, or any ingredient in the formulation
- Pregnancy, actively trying to conceive, or breastfeeding
The thyroid tumor warning is a boxed warning on these medications, based on rodent studies. It is the single most important question on the intake form.
Use with caution — tell your prescriber
- History of pancreatitis
- Gallbladder disease or gallstones
- Severe gastrointestinal disease, including gastroparesis
- Diabetic retinopathy
- Kidney disease or a history of severe dehydration
- History of an eating disorder
- Type 1 diabetes (these drugs are not a substitute for insulin)
- Current use of insulin or sulfonylureas — doses may need adjusting to avoid low blood sugar
None of the items in the second list automatically disqualify you. They are things a prescriber needs to weigh, and in several cases they change how you should be monitored or how quickly your dose should be increased.
What Telehealth Providers Screen For
Screening depth varies widely between providers. Understanding the spectrum helps you judge whether a service is being appropriately careful or just processing orders.
Nearly every provider asks
- Height, weight, and calculated BMI
- Age and state of residence
- Personal and family history of thyroid cancer and MEN 2
- Pregnancy and breastfeeding status
- Current medications and allergies
- History of pancreatitis or gallbladder problems
- Prior experience with GLP-1 medication and current dose, if any
More thorough providers also
- Require a synchronous video or phone visit rather than a form alone
- Request recent lab work or order labs as part of onboarding
- Ask for a blood pressure reading
- Review prior weight loss attempts and eating patterns
- Screen for eating disorders and mental health history
- Schedule structured follow-ups before approving dose increases
A useful signal: a provider that can be talked out of prescribing is generally safer than one that cannot. If every answer you give leads to instant approval, the screening is decorative.
Do You Need Lab Work?
Lab requirements are one of the biggest differences between providers. There is no universal rule, and practice varies:
- No labs required: many asynchronous telehealth services prescribe based on your questionnaire alone. This is faster and cheaper, and it is how most of the low-cost compounded programs operate.
- Labs recommended but optional: the provider suggests baseline bloodwork and may offer an at-home kit or a lab order, but will still prescribe without it.
- Labs required: more clinically conservative programs — and most brand-name-focused or insurance-billing programs — want a metabolic panel, A1C, and sometimes thyroid and lipid panels before starting.
If you have not had bloodwork in the last year, getting baseline labs is worth doing regardless of whether your provider demands it. An A1C and a comprehensive metabolic panel establish a starting point, can reveal a weight-related condition you did not know you had (which may help you qualify), and give you something to compare against later.
State and Age Restrictions
Telehealth prescribing is regulated state by state, and no provider serves every state identically. Two practical consequences:
- Coverage gaps. Most national telehealth companies operate in the large majority of states but exclude a handful. If you live in a smaller or more tightly regulated state, confirm availability before paying anything.
- Visit-type rules. Some states require a real-time video or phone visit before a first prescription, so a provider that is form-only elsewhere may require a live appointment for you.
- Compounded medication rules. State pharmacy boards regulate what compounding pharmacies may ship into their state, which occasionally limits which formulations you can receive.
On age: most telehealth weight loss services are adults-only (18+). Prescribing to adolescents happens in specialist pediatric and obesity medicine settings, not through general-purpose telehealth intake.
What to Do If You Are Denied
Being turned down by one provider does not mean GLP-1 treatment is off the table forever. What you should do next depends on why you were denied.
If you were denied on BMI
Check whether you have an undocumented weight-related condition. Prediabetes, sleep apnea, high blood pressure, and PCOS are all commonly undiagnosed, and any of them can move you from "BMI 27, denied" to "BMI 27 with a comorbidity, eligible." A physical with your primary care provider and a basic lab panel is the right next step — not shopping for a provider with looser standards.
If you were denied on medical history
Take this one seriously. A thyroid cancer history or MEN 2 diagnosis is a hard stop that applies at every legitimate provider. Trying a different service until someone says yes means finding the provider with the weakest screening — which is exactly the provider you least want managing your care. Talk to your doctor about non-GLP-1 options instead.
If you were denied on state availability
This is the easiest problem to solve — it is a business limitation, not a medical judgment. Another provider almost certainly serves your state. Our provider reviews note availability where companies publish it.
If your insurance denied coverage
Insurance denial is a separate issue from clinical eligibility — you can be perfectly eligible and still be denied coverage. Prior authorization and appeals are covered in our insurance coverage guide, and cash-pay compounded programs are the common fallback.
Frequently Asked Questions
Can I get a GLP-1 with a BMI under 27?
Not under standard weight management criteria. Some providers market lower-dose or "microdosing" programs to people below the threshold, but that is prescribing outside the approved indication. If a service approves you at a BMI of 24 without discussion, treat that as a warning about their standards generally.
Does a family history of type 2 diabetes help me qualify?
Family history alone typically does not count — the criteria look at conditions you have. However, family history is a good reason to get an A1C test, which may reveal prediabetes that does count.
I have a thyroid nodule, not thyroid cancer. Am I disqualified?
The contraindication is specifically medullary thyroid carcinoma and MEN 2, not thyroid nodules or hypothyroidism generally. Disclose it and let the prescriber make the call — many people with treated hypothyroidism take these medications.
Do compounded providers use different eligibility rules?
The clinical criteria should be the same. In practice, screening rigor at cash-pay compounded programs is often lighter — fewer labs, more questionnaire-only approvals. Same medication class, same contraindications, different amount of gatekeeping. See our compounded vs brand-name comparison.
What if I want to stop birth control or get pregnant?
GLP-1 medications are not used during pregnancy, and guidance is to stop well before conceiving. Separately, these drugs can affect how oral medications are absorbed, so discuss contraception with your prescriber rather than assuming your current method behaves the same way.
Medical disclaimer: This article is general educational information and is not medical advice. Eligibility for any prescription medication is a clinical decision that must be made by a licensed healthcare provider who knows your full medical history. Do not start, stop, or change any medication based on this page.
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