Do I Qualify for a GLP-1? BMI, Conditions and Exclusions

Written by the DoIQualify editorial team · Sources: FDA prescribing information (DailyMed), CDC, Medicare.gov · Last reviewed 19 September 2026 · About DoIQualify

Do I qualify for a GLP-1? The two routes

With a BMI of 30 or higher, you may meet common criteria on BMI alone. With a BMI of 27 to 29.9, you may meet them only if you also have at least one weight-related condition, such as high blood pressure or high cholesterol. Work out your number with the BMI calculator. On either route, a licensed clinician makes every prescribing decision.

What BMI do you need for a GLP-1?

You need a BMI of 30 or higher, or a BMI of 27 to 29.9 with at least one weight-related condition. The current labels say this in words, not numbers: Wegovy, Zepbound, Saxenda and Foundayo are each indicated for adults with obesity, or adults with overweight “in the presence of at least one weight-related comorbid condition”.

The numbers come from the trials behind those labels. Zepbound’s main trial enrolled 2,539 adults with “obesity (BMI ≥30 kg/m²), or with overweight (BMI 27 to <30 kg/m²)” plus a comorbid condition, and Foundayo’s enrolled 3,127 adults on the same definition. Saxenda’s label uses 27 to 29.9.

The CDC’s adult BMI categories set overweight at 25 to under 30 and obesity at 30 or greater, split into Class 1 (30 to under 35), Class 2 (35 to under 40) and Class 3 (40 or greater). The drug trials started at 27, not 25, so a BMI of 25 or 26 falls outside what was studied. Work yours out with the BMI calculator.

Which health conditions count at a BMI of 27 to 29.9?

High blood pressure and abnormal cholesterol are named on every label, and sleep apnea and cardiovascular disease are named on two. The Zepbound and Foundayo trials list “dyslipidemia, hypertension, obstructive sleep apnea, or cardiovascular disease”. The Wegovy and Saxenda trials list “treated or untreated dyslipidemia or hypertension”.

Each list is introduced with “such as”, so none is exhaustive, and treated conditions count. If your blood pressure is controlled by medication, you still have hypertension for this purpose.

Type 2 diabetes is handled separately. The main weight-management trials excluded it, and the labels describe separate trials in adults with type 2 diabetes and a BMI of 27 or higher. Programs publish their own condition lists, which can be longer than the labels. The DoIQualify quiz asks about the common ones and shows whether you may meet common criteria.

Can you get a GLP-1 with a BMI under 27?

Not under a weight-management label, because none was studied or approved below a BMI of 27. Two other routes exist, and both depend on a diagnosis, not on weight.

The first is type 2 diabetes. Ozempic is indicated to improve glycemic control in adults with type 2 diabetes, and Mounjaro in adults and children aged 10 and older with type 2 diabetes. Neither indication sets a BMI.

The second is heart disease, and it still needs a BMI of 27. Wegovy is indicated to reduce the risk of major cardiovascular events in adults with established cardiovascular disease and either obesity or overweight, and its trial required a “BMI of 27 kg/m² or greater” with a prior heart attack, prior stroke or peripheral arterial disease.

A clinician may legally prescribe outside a label, but that is a clinical judgment you cannot apply for. DoIQualify does not show a program to anyone whose answers fall below the label criteria.

Which GLP-1 medications are FDA-approved for weight loss?

Five products carry a weight-management indication as of September 2026. Ozempic, Mounjaro and Rybelsus contain the same or related ingredients but are approved for type 2 diabetes, not weight loss.

Compounded semaglutide and tirzepatide are not on this list. The FDA states that “compounded drugs are not FDA approved”, which means the agency does not review them for safety, effectiveness or quality before they are sold. Compounded vs brand-name GLP-1s covers what that means in practice, and oral vs injectable GLP-1s compares the two forms.

What medical history rules you out of a GLP-1?

Two things rule you out on every label: a personal or family history of medullary thyroid carcinoma (MTC), or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Each carries a boxed warning because the drugs caused thyroid C-cell tumors in rodents, and the Wegovy label says it is unknown whether they do so in humans. A prior serious allergic reaction to the drug is the other listed contraindication.

Pregnancy is a stop signal. Both the Wegovy and Zepbound labels say weight loss “offers no benefit to a pregnant patient and may cause fetal harm”. Wegovy’s says to discontinue “at least 2 months before” a planned pregnancy because semaglutide stays in the body a long time.

Beyond those, the labels list conditions a clinician weighs case by case, not automatic exclusions:

• A history of pancreatitis or gallbladder disease, both listed under warnings.
• Severe gastroparesis. Wegovy is “not recommended in patients with severe gastroparesis”.
• Kidney problems, because vomiting and diarrhea can cause dehydration that injures the kidneys.
• Diabetic retinopathy, if you have type 2 diabetes.
• Insulin or sulfonylurea use, which raises the risk of low blood sugar.
• Oral birth control with Zepbound. Its label advises a non-oral or barrier method for 4 weeks after starting and after each dose increase.

The full adverse-reaction picture is in GLP-1 side effects: what the labels report.

Do I qualify for Wegovy, Zepbound or a GLP-1 pill?

The same label criteria apply to each weight-management product: adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition. That covers Wegovy injection and tablets, Zepbound, Saxenda and Foundayo. The product table above shows how each is taken and its approved ages. Wegovy tablets and Foundayo are the daily pills, and oral vs injectable GLP-1s compares the two forms. A clinician decides which product, if any, suits you.

Is there an age limit for GLP-1 weight-loss drugs?

The lower limit is 12 for two products and 18 for the rest, and no label sets an upper limit. Wegovy injection is approved from age 12 for obesity, which its pediatric trial defined as a BMI at or above the 95th percentile for age and sex. Saxenda is approved from age 12 for patients above 60 kg. Wegovy tablets, Zepbound and Foundayo have not been established as safe or effective in pediatric patients.

Older adults were a small share of the trials. In Wegovy’s weight trials 9% of treated patients were 65 to under 75 and 1% were 75 or older. In Zepbound’s, 9% were 65 or older and 0.5% were 75 or older, and its label reports no overall difference in safety or effectiveness by age.

DoIQualify’s quiz is for adults: our terms require you to be at least 18.

Does Medicare use the same BMI criteria?

No. Medicare’s temporary GLP-1 Bridge, which Medicare.gov says runs from July 1, 2026 to December 31, 2027, uses three tiers. You must be 18 or older, have Part D drug coverage, and meet one of these when you start:

• A BMI of 35 or higher.
• A BMI of 30 or higher with diastolic heart failure, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher.
• A BMI of 27 or higher with prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease.

You are not eligible if Part D already covers your GLP-1, or if you have type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease, because a Part D plan may cover the drug for those. Your provider must certify that you are using it as part of a diet and exercise program. What Medicare, Medicaid and commercial plans charge is in GLP-1 costs by route.

What does a clinician check before prescribing?

A clinician checks the label’s contraindications first, then the warnings that apply to you. In practice that means questions about:

• Thyroid cancer in you or your family, and MEN 2.
• Pregnancy, breastfeeding and plans to conceive.
• Past pancreatitis, gallstones or gallbladder surgery.
• Every medication you take, especially insulin, sulfonylureas and oral contraceptives.
• Kidney function and, with type 2 diabetes, eye disease.
• Your height, weight and weight-related diagnoses, which set the BMI route.

Answer accurately. The intake is the clinical record the prescriber relies on, and a wrong answer can hide a contraindication. What happens in an online GLP-1 consultation walks through the steps after you submit it.

Does meeting the criteria mean you will be prescribed?

No. Meeting the BMI and condition criteria means a clinician can consider you under the label; it is not an approval. The prescriber can decline on any of the warnings above, ask for labs first, or suggest a different treatment.

Programs also add non-clinical filters, and they differ. Direct Meds does not serve Mississippi or Louisiana. JRNYS lists brand-name products and we could not confirm a compounded option, while TrimRx and OMZO price both compounded and brand-name medication in their terms. Compare all 33 programs by price, medication type and terms once you know which route you are on.

What it costs once you qualify

As of September 2026, FDA-approved brand-name GLP-1s bought through the manufacturers’ self-pay programs run $149 to $449 a month, depending on drug and dose. The programs DoIQualify tracks that include compounded medication charge $129 to $299 a month ongoing; compounded GLP-1s are not FDA-approved products. With commercial insurance that covers the drug, a manufacturer savings card starts from $25 a month, and Medicare’s GLP-1 Bridge costs eligible members $50 a month. What GLP-1s cost in 2026 gives the sources and dose tiers, and GLP-1 hidden fees covers what a headline price leaves out.

How the DoIQualify check works, and how we’re paid

The DoIQualify quiz asks 8 questions. There is no account and no phone number, and nothing is sent to a provider until you choose to enroll. We may earn a referral fee if you enroll; it doesn’t change your result. We are not a provider and never see your medical record. What is DoIQualify? explains who we are, and our affiliate disclosure explains the fees.

Do I qualify? GLP-1 eligibility FAQ

This article is informational and not medical advice. A licensed clinician makes every prescribing decision. Medical disclaimer