Do I Qualify for GLP-1 Therapy? BMI and Medical Criteria

The standard indication for chronic weight management is a BMI of 30 or above, or a BMI of 27 or above with at least one weight-related comorbidity. BMI is calculated from height and weight, and you can estimate yours in under a minute.

BMI is an imperfect measure — it does not distinguish muscle from fat, which is why very muscular patients can register as overweight. It remains the standard screening threshold, but it is a starting point for the conversation rather than the whole assessment.

Conditions that commonly qualify a patient at BMI 27 or above include type 2 diabetes, prediabetes, hypertension, dyslipidemia, obstructive sleep apnea, non-alcoholic fatty liver disease, PCOS and osteoarthritis attributable to weight.

Many patients have one of these without knowing it. This is a substantial part of why the initial workup includes labs — the evaluation frequently changes both the indication and the plan.

GLP-1 receptor agonists are contraindicated in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2, and in patients who are pregnant, planning pregnancy or breastfeeding.

Relative contraindications requiring careful physician judgment include a history of pancreatitis, active gallbladder disease, severe gastroparesis, active eating disorders and certain concurrent medications. None of these is automatically disqualifying — each requires an individual assessment.

A complete medical and weight history, current medications and supplements, family history, BMI and comorbidity assessment, and labs when clinically indicated — typically a metabolic panel, A1c and thyroid studies.

Texas requires a physician-patient relationship and a good faith examination before a prescription is issued. Any source offering a GLP-1 without that is operating outside the rules that exist to protect you.

Falling below the threshold does not end the conversation. A medical weight-loss program can address an untreated thyroid issue, an insulin-resistance pattern, a medication that is driving weight gain or a sleep disorder — and body contouring and muscle-toning treatments address localized concerns that were never a medication problem in the first place.