"Am I eligible for GLP-1 therapy?" turns on a combination of BMI, comorbidities, indication, and the specific provider's criteria. Here's the framework.

FDA-approved label criteria

Wegovy (weight management)

BMI ≥30 (obesity), OR
BMI ≥27 with weight-related comorbidity (hypertension, T2D, dyslipidemia, OSA, CVD).

Wegovy CV indication (March 2024)

BMI ≥27 AND established cardiovascular disease.
Does not require diabetes.

Zepbound (weight management)

BMI ≥30, OR BMI ≥27 with comorbidity.

Zepbound OSA indication (December 2024)

BMI ≥30 (obesity), AND moderate-to-severe OSA (AHI ≥15).

Ozempic / Mounjaro (T2D)

Type 2 diabetes diagnosis. No BMI threshold.

Telehealth provider criteria

Cash-pay providers typically apply criteria similar to FDA labels but may be more flexible:

BMI ≥27 typical lower threshold, sometimes ≥25 with comorbidity.
BMI 30+ usually accepted without comorbidity requirement.
BMI 35+ streamlined approval.
Cardiometabolic comorbidity (T2D, prediabetes, hypertension, dyslipidemia, MASLD/MASH, OSA, PCOS) typically counts as qualifying.

Insurance prior auth (typical)

BMI threshold (≥30 or ≥27 with comorbidity).
Documented lifestyle modification (3–6 months).
Specific comorbidity documentation if BMI 27–30.
Sometimes step therapy.

Calculating BMI

BMI = weight (kg) / [height (m)]² OR weight (lb) × 703 / [height (in)]². BMI has limitations but is the criterion in current labels and insurance criteria.

Who is NOT eligible

Personal or family history of medullary thyroid carcinoma or MEN-2.
Pregnancy or planning pregnancy within washout window.
Active severe GI disease.
Active eating disorder requiring specialized care.
Children under 12.
BMI below threshold with no qualifying comorbidity.