The Quick Answer
Most people who want GLP-1 medications can get them. The main requirements are BMI-based, and the absolute contraindications are relatively rare. Let's break it down clearly.
Hard Stops (Absolute Contraindications)
These conditions mean GLP-1 medications are not safe for you. No legitimate provider will prescribe if you have:
🚫 You Cannot Take GLP-1s If:
- Personal or family history of medullary thyroid carcinoma (MTC) — GLP-1s carry a black box warning about thyroid C-cell tumors
- Multiple Endocrine Neoplasia syndrome type 2 (MEN2) — Related to MTC risk
- Currently pregnant or breastfeeding — Animal studies show fetal harm
- History of severe pancreatitis — GLP-1s can increase risk
- Type 1 diabetes — Most telehealth providers won't manage this remotely due to DKA risk
BMI Requirements
FDA guidelines are straightforward:
✓ You Likely Qualify If:
BMI 30 or higher — You qualify based on obesity alone
BMI 27-29.9 + weight-related condition — You qualify if you also have: Type 2 diabetes, high blood pressure, high cholesterol, sleep apnea, PCOS, or fatty liver disease
🚫 You Likely Don't Qualify If:
BMI under 27 — The risk-benefit profile doesn't support prescribing for purely cosmetic weight loss in non-overweight individuals
Quick BMI reference: For someone 5'6", BMI 30 is about 186 lbs. For someone 5'10", it's about 209 lbs. Not sure? Most provider quizzes calculate it automatically.
Conditions That Require Caution (But Aren't Disqualifying)
⚠️ Requires Discussion With Provider:
- History of eating disorders — Providers screen carefully, but a history doesn't automatically disqualify you
- Kidney disease — May need dose adjustments or more monitoring
- Gallbladder disease — GLP-1s can increase gallstone risk; weigh benefits vs risks
- Diabetic retinopathy — Rapid blood sugar changes can temporarily worsen eye issues
- Current medications — Insulin or sulfonylureas may need adjustment to prevent low blood sugar
Things That DON'T Disqualify You
Common misconceptions about what prevents eligibility:
✓ These Are NOT Disqualifying:
- Being over 65 — Age alone isn't a contraindication
- Having tried and "failed" diets — Actually, this supports the medical need
- Not having diabetes — GLP-1s are approved for weight loss without diabetes
- Taking blood pressure or cholesterol meds — These are fine to continue
- Having had weight loss surgery in the past — Depends on the situation
- Mental health conditions — Depression, anxiety, etc. aren't contraindications (though providers will screen for suicidal ideation as a precaution)
What If You're Borderline?
If your BMI is close to 27 but you have weight-related health issues, document them. A diagnosis of prediabetes, elevated blood pressure readings, or sleep apnea can tip you into eligibility.
Some providers are more flexible than others. If one declines you, try another—especially if you have documented comorbidities that weren't properly considered.
Key point: Getting declined by one telehealth provider doesn't mean you're permanently ineligible. Requirements and review processes vary. Document your health conditions and try elsewhere if needed.
Planning to Get Pregnant?
GLP-1 medications should be stopped at least 2 months before trying to conceive. If pregnancy is on your horizon, discuss timing with your provider. You can still use GLP-1s—just plan the transition.
The Bottom Line
Unless you have one of the hard-stop contraindications (MTC/MEN2 history, pregnancy, severe pancreatitis, Type 1 diabetes), you're probably eligible if your BMI qualifies. Most people who think they might not qualify actually do.
The intake quiz takes a few minutes. If you're curious, just try it—you'll find out quickly whether you meet the criteria.
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