BMI Requirements for Eligibility
The FDA-approved criteria for weight loss medications like Wegovy and Zepbound require a BMI of 30 or higher (classified as obesity) or a BMI of 27 or higher with at least one weight-related health condition such as type 2 diabetes, high blood pressure, high cholesterol, or obstructive sleep apnea. Many telehealth providers follow these same guidelines, though some may have slightly different thresholds for compounded medications. Your provider will calculate your BMI during the initial evaluation and determine whether you meet the clinical criteria.
Medical Conditions That May Disqualify You
Certain health conditions make GLP-1 medications unsafe. These include a personal or family history of medullary thyroid carcinoma (MTC), a history of multiple endocrine neoplasia syndrome type 2 (MEN 2), a history of pancreatitis, and known hypersensitivity to semaglutide or tirzepatide. Patients with severe gastrointestinal disorders, including gastroparesis, may also be advised against these medications. Pregnancy and breastfeeding are absolute contraindications — you should stop the medication at least two months before planning to conceive.
Age and Other Considerations
Most providers prescribe GLP-1 medications to adults aged 18 and older. Wegovy has FDA approval for adolescents aged 12 and up with obesity, but this is typically managed through in-person pediatric endocrinologists rather than telehealth platforms. For older adults, providers will consider factors like kidney function, existing medications, and overall health status. There is no strict upper age limit, but a thorough medical evaluation becomes especially important for patients over 65.
Medications That May Interact
GLP-1 medications can interact with other drugs, particularly insulin and sulfonylureas (which may increase the risk of hypoglycemia when combined). Because GLP-1 agonists slow gastric emptying, they can also affect the absorption of oral medications. Your provider will review your full medication list during the evaluation process. If you take oral birth control, blood thinners, or thyroid medication, discuss timing and potential interactions with your provider before starting treatment. Learn more about potential side effects in our semaglutide side effects guide.
The Evaluation Process
Most telehealth providers follow a straightforward process: you complete a detailed health questionnaire, provide your medical history and current medications, and have a consultation with a licensed provider (usually via video or asynchronous message). Some providers require recent lab work, while others may order labs as part of their program. The evaluation typically takes one to three days, and if approved, your medication can be shipped within a week. For tips on choosing the right platform, read our guide on selecting a telehealth provider.
What If You Don't Qualify?
If you don't meet the criteria for GLP-1 medication, you still have options. Providers may recommend oral weight loss medications like metformin or bupropion-naltrexone, which have different eligibility criteria. Structured programs that focus on nutrition, behavioral change, and exercise can also produce meaningful results. Some patients who don't initially qualify may become eligible as their health profile changes. The key is to work with a licensed provider who can evaluate all available options and build a plan tailored to your situation. Take our quiz to find a provider that matches your specific needs.