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See if you qualify →To get weight loss drugs, you need a prescription from a licensed clinician. Most GLP-1 medications like Wegovy (semaglutide) and Zepbound (tirzepatide) are considered for adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition. A primary care clinician, specialist, or telehealth provider can evaluate you. [1][2][3]
What counts as a “weight loss drug” today?
Weight loss drugs are prescription or over-the-counter medicines used with nutrition, activity, sleep, and behavior changes to help manage excess weight. Obesity is recognized as a chronic disease, and medication may be considered when lifestyle care alone is not enough, but every option has side effects, limits, and contraindications. [1][5]
FDA-approved GLP-1s and incretin medicines
Wegovy (semaglutide, a GLP-1 receptor agonist; also available as a compounded formulation through licensed 503A pharmacies when appropriate) is FDA-approved for chronic weight management in certain adults and adolescents. The FDA-approved label describes 0.25 mg once weekly as the initial dose for the first 4 weeks, with stepwise escalation to a 2.4 mg once-weekly maintenance dose; the same label lists nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, gallbladder disease, pancreatitis warnings, pregnancy risk, and a boxed warning about thyroid C-cell tumors. [2]
In the STEP 1 trial, adults without diabetes received semaglutide 2.4 mg subcutaneously once weekly plus lifestyle intervention, and the semaglutide group had greater average weight loss than placebo; individual results vary, and gastrointestinal side effects were common in the trial. [6]
Zepbound (tirzepatide, a GIP/GLP-1 dual agonist; also available as a compounded formulation through licensed 503A pharmacies when appropriate) is FDA-approved for chronic weight management in eligible adults. The FDA-approved label describes 2.5 mg once weekly as the starting dose and 5 mg, 10 mg, or 15 mg once weekly as maintenance doses; the label also lists nausea, diarrhea, vomiting, constipation, abdominal pain, gallbladder disease, pancreatitis warnings, pregnancy risk, and a boxed warning about thyroid C-cell tumors. [3]
In the SURMOUNT-1 trial, adults with obesity or overweight and at least one weight-related complication received tirzepatide 5 mg, 10 mg, or 15 mg once weekly or placebo, and tirzepatide groups had greater average weight loss than placebo; individual results vary, and gastrointestinal side effects were common. [7]
Saxenda (liraglutide, a GLP-1 receptor agonist) is FDA-approved for chronic weight management in eligible adults and some adolescents. The FDA-approved label describes 0.6 mg once daily as the initial dose and 3 mg once daily as the target maintenance dose, and it lists nausea, vomiting, diarrhea, constipation, low blood sugar in some settings, gallbladder problems, pancreatitis warnings, pregnancy risk, and a boxed warning about thyroid C-cell tumors. [8]
Ozempic (semaglutide) and Mounjaro (tirzepatide) are FDA-approved for type 2 diabetes, not chronic weight management under those brand labels. Some clinicians may discuss them when diabetes is also present, but off-label use for weight loss alone should be reviewed carefully and is not the same as using an FDA-approved weight management label. [9][10]
Some people search for orforglipron, an oral GLP-1 receptor agonist under study, sometimes with the name Foundayo. Orforglipron is not FDA-approved for chronic weight management at the time of this writing; it should not be used outside an FDA-approved label, a legitimate clinical trial, or another lawful pathway reviewed by a clinician, and current FDA labeling should be checked before any decision. [11]
Older oral medications
Older options include phentermine (Adipex-P, a sympathomimetic appetite suppressant), phentermine-topiramate (Qsymia), bupropion-naltrexone (Contrave), and orlistat (Xenical by prescription; Alli over the counter at a lower strength). These can help some people, but they also have important side effects and contraindications, including heart-rate or blood-pressure concerns with stimulant-type medicines, pregnancy risk with Qsymia, neuropsychiatric and seizure warnings with Contrave, and oily stools or fat-soluble vitamin issues with orlistat. [12][13][14][15]
Setmelanotide (Imcivree) is different. It is FDA-approved for chronic weight management only in specific rare genetic conditions, not general obesity; the label lists injection-site reactions, skin darkening, nausea, headache, depression, and sexual side effects. [16]
Compounded GLP-1s from 503A pharmacies
Compounded semaglutide via a 503A pharmacy and compounded tirzepatide via a 503A pharmacy are custom-made medications prepared for a specific patient prescription by a licensed pharmacy. Compounded GLP-1s are not FDA-approved products, and FDA does not verify them for safety, effectiveness, or quality before they are dispensed; they should only be used when prescribed by a licensed clinician and filled by a properly licensed pharmacy. [4]
A compounded option may be discussed when a clinician believes it is appropriate and lawful for a specific patient. Side effects and contraindications can still apply because semaglutide and tirzepatide work through incretin pathways, so screening and follow-up still matter. [2][3][4]
Do you qualify for a weight loss prescription?
Many FDA-approved chronic weight management medicines use BMI eligibility criteria of BMI 30 or higher, or BMI 27 or higher with at least one weight-related condition. BMI is only one screening tool, so a clinician also reviews your health history, goals, medications, pregnancy status, and safety risks. [1][2][3]
BMI thresholds: 30, or 27 with a comorbidity
A common threshold is BMI ≥30, which falls in the obesity range, or BMI ≥27 with a condition related to weight. Examples include high blood pressure, abnormal cholesterol, type 2 diabetes, obstructive sleep apnea, or cardiovascular disease, depending on the medication label and the clinician’s assessment. [1][2][3]
Weight-related conditions that count
Weight-related conditions are health problems that excess weight can worsen. These may include type 2 diabetes, hypertension, dyslipidemia, sleep apnea, fatty liver disease, or joint pain, but the exact list depends on the medication, insurer, and medical review. Benefits must be balanced with side effects, cost, long-term use, and contraindications. [1][5]
Who should not take GLP-1s
GLP-1 and GIP/GLP-1 medicines are not right for everyone. Wegovy, Saxenda, and Zepbound labels warn against use in people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, often called MEN2; they should not be used during pregnancy, and clinicians use caution in people with pancreatitis history or certain gallbladder, kidney, or digestive problems. [2][3][8]
Tell your clinician if you have had pancreatitis, gallbladder disease, severe stomach-emptying problems, kidney disease, eating disorder history, depression or suicidal thoughts, diabetes medicines that can cause low blood sugar, or plans for pregnancy. The goal is not just to get a prescription; it is to choose a safe plan. [2][3][8][13]
Who can prescribe weight loss medication?
A licensed clinician can prescribe weight loss medication if it is medically appropriate and allowed in their state and practice setting. This may include a physician, nurse practitioner, or physician assistant, depending on local rules and the type of medication. [1]
Primary care clinicians
Primary care is a common starting point because your clinician may already know your blood pressure, lab history, medications, and weight-related conditions. They can discuss expected benefits, common side effects, contraindications, insurance paperwork, and whether specialist care is needed. [1][5]
Obesity medicine specialists and endocrinologists
Obesity medicine specialists and endocrinologists often help when weight is tied to diabetes, hormonal conditions, complex medication lists, or prior medication problems. They can also help monitor side effects and adjust the plan over time, especially when other conditions affect medication choice. [5]
Telehealth providers
Telehealth prescribing can be an option when a licensed clinician can safely evaluate your history, BMI, contraindications, and follow-up needs through a virtual visit or online intake. Telehealth is still medical care: the clinician may request labs, vital signs, prior records, or in-person care if needed. [1][4]
How do you actually get the prescription? A step-by-step walkthrough
Getting a prescription usually takes 5 steps: gather your information, book an evaluation, review options and risks, receive a prescription if appropriate, and follow up. The process is meant to confirm that the medicine fits your health needs, not just your weight goal. [1][2][3]
- 1Gather your health history and BMI. Write down your height, weight, current medications, allergies, past weight loss attempts, pregnancy plans, and any history of pancreatitis, gallbladder disease, thyroid cancer, MEN2, diabetes, or stomach-emptying problems. [1][2][3]
- 2Book an evaluation. This can be with primary care, an obesity medicine clinician, an endocrinologist, or a licensed telehealth provider. The clinician may ask for blood pressure, labs, or prior records. [1][5]
- 3Discuss options, side effects, and goals. Ask about FDA-approved GLP-1s, compounded GLP-1s when appropriate, older oral medicines, expected follow-up, side effects, contraindications, and what happens if you stop. [1][2][3][4]
- 4Receive a prescription if appropriate. FDA labels for GLP-1 and GIP/GLP-1 medicines describe low initial doses followed by gradual escalation, but your clinician and the medication label guide any plan. Do not start or change a dose without clinician direction. [2][3][8]
- 5Follow up for monitoring. Follow-up often happens around dose changes and may include side-effect checks, weight trend review, blood pressure, glucose concerns, and discussion of whether the medication still fits your goals. [1][2][3]
How do you ask your doctor for weight loss medication?
A good way to ask is direct and practical: “I’d like to talk about whether weight loss medication is safe and appropriate for me.” Bring your BMI, health history, and questions, and be open to hearing that a different option may be safer. [1][5]
Sample script for the conversation
You can say: “My BMI is about [number], and I have [condition, if any]. I’ve tried [nutrition, activity, sleep, or prior programs]. Could we review whether an FDA-approved weight loss medication or another evidence-based option makes sense for me, including side effects, costs, follow-up, and reasons I should not take it?”
What to bring to the visit
- Your current weight, height, and recent weight trend.
- A list of prescription drugs, over-the-counter medicines, and supplements.
- Any history of pancreatitis, gallbladder disease, thyroid cancer, MEN2, kidney disease, diabetes, stomach-emptying problems, depression, eating disorder, or pregnancy plans. [2][3][8][13]
- Recent labs if you have them, such as A1C, lipids, liver enzymes, kidney function, and thyroid tests.
- Insurance information and any prior authorization forms if your plan requires them.
How much do weight loss drugs cost, and does insurance cover them?
The cost of GLP-1 weight loss medication can range from a covered copay to more than $1,000 per month for some brand-name products without insurance or savings support. Coverage depends on your plan, diagnosis, prior authorization, pharmacy benefit, and whether your employer excludes weight loss medications. [17][18]
Cash price of brand-name GLP-1s
Brand-name GLP-1 and GIP/GLP-1 medicines often have high list prices, and the pharmacy cash price may vary. If a medication is covered, your plan may still require proof of BMI, a weight-related condition, prior lifestyle attempts, or step therapy; side effects and contraindications still matter even when insurance covers the drug. [2][3][17][18]
Manufacturer savings cards
Some manufacturers offer savings cards for eligible commercially insured patients, but these programs have rules, expiration dates, and exclusions. Government insurance plans often cannot use manufacturer coupons, and savings programs do not replace a medical evaluation. [17][18]
Compounded semaglutide and tirzepatide as a lower-cost path
Compounded semaglutide and compounded tirzepatide may be discussed as a lower-cost path when a clinician determines that a compounded prescription is appropriate and lawful. These medications are dispensed by licensed 503A compounding pharmacies for individual prescriptions, but they are not FDA-approved products and FDA does not review each compounded product for safety, effectiveness, or quality before dispensing. [4]
Chia is one telehealth option that offers clinician-reviewed access to compounded GLP-1s and longevity peptides through licensed 503A pharmacy partners when appropriate; patients can also work with their primary care clinician, a local specialist, or another licensed telehealth service.
3-min quiz
See if you’re eligible
A licensed clinician can review your BMI, medical history, contraindications, and goals to help decide whether a weight loss prescription is appropriate.
What should you expect once you start?
Once you start a weight loss medication, expect monitoring, side-effect check-ins, and gradual changes rather than instant results. In clinical trials, GLP-1 and GIP/GLP-1 medicines led to average weight loss greater than placebo, but individual results vary and side effects are common. [6][7]
Titration schedule
Many injectable incretin medicines use gradual dose escalation over several months to improve tolerability. The FDA-approved Saxenda label describes 0.6 mg once daily as the initial dose and 3 mg once daily as the target maintenance dose; the Wegovy and Zepbound labels describe once-weekly escalation schedules. This article does not provide dosing instructions. [2][3][8]
Common side effects
Common GLP-1 side effects include nausea, vomiting, diarrhea, constipation, stomach pain, burping, and reduced appetite. Serious but less common risks can include pancreatitis, gallbladder disease, kidney problems from dehydration, allergic reactions, and low blood sugar when combined with certain diabetes medicines. [2][3][8]
Older oral medications have different side effects. Phentermine can raise heart rate or blood pressure, Qsymia can harm a fetus and needs pregnancy precautions, Contrave has a boxed warning about suicidal thoughts and is not used in seizure disorder, and orlistat can cause oily stools and reduce absorption of some vitamins. [12][13][14][15]
How long you stay on the medication
Obesity is often a chronic condition, so some people use medication long term if it remains safe, helpful, and affordable. In the STEP 1 extension, participants who stopped semaglutide after trial treatment regained some weight on average; individual results vary, and stopping should be discussed with a clinician along with side effects, goals, and alternatives. [5][19]
How do brand-name, compounded, and older oral medications compare?
The right choice depends on FDA status, medical history, cost, access, and side effects. This table gives a high-level comparison; it is not a prescription recommendation. [1][2][3][4]
| Option | Examples | FDA status | Potential benefits | Key risks or limits |
|---|---|---|---|---|
| Brand-name incretin medications | Wegovy (semaglutide), Zepbound (tirzepatide), Saxenda (liraglutide) | FDA-approved for chronic weight management in eligible patients under their labels. [2][3][8] | Clinical trials show greater average weight loss than placebo when used with lifestyle support; individual results vary. [6][7] | Nausea, vomiting, diarrhea, constipation, gallbladder risks, rare pancreatitis, pregnancy contraindication, and thyroid C-cell tumor warning for certain products. [2][3][8] |
| Compounded GLP-1 medications | Compounded semaglutide, compounded tirzepatide from licensed 503A pharmacies | Not FDA-approved products; may be prepared for individual prescriptions under compounding rules. [4] | May improve access or affordability when clinically appropriate and lawful. | FDA does not review compounded products for safety, effectiveness, or quality before dispensing; same active-ingredient risks may apply. [2][3][4] |
| Older oral prescription medications | Phentermine, Qsymia, Contrave, Xenical | FDA-approved uses vary by product; some are short-term and some are chronic weight management. [12][13][14][15] | May be lower cost and easier to take for some people. | Different contraindications: stimulant effects, pregnancy risk, seizure risk, psychiatric warnings, and gastrointestinal side effects, depending on the drug. [12][13][14][15] |
| Rare-disease medication | Imcivree (setmelanotide) | FDA-approved only for specific rare genetic obesity conditions. [16] | May reduce hunger and weight in eligible genetic conditions. | Not for general obesity; can cause injection-site reactions, skin darkening, nausea, headache, depression, and sexual side effects. [16] |
| Investigational or status-changing products | Orforglipron, searched by some patients as Foundayo | Not FDA-approved for chronic weight management at the time of this writing; check FDA labeling before use. [11] | Oral GLP-1 options are an area of active research. | Safety, approval status, labeling, and appropriate use must be confirmed through FDA sources and clinician review. [11] |
Frequently asked questions
Many chronic weight management medications use BMI 30 or higher, or BMI 27 or higher with a weight-related condition, but the exact requirement depends on the medication label, your health history, and insurance rules. [1][2][3]
You may be able to get semaglutide or tirzepatide through a licensed telehealth provider if a clinician completes an evaluation and decides it is appropriate. Online access should still include screening for contraindications, side effects, pregnancy status, and follow-up needs. [1][2][3]
No. Compounded medications are not FDA-approved products. They may be prepared by licensed 503A pharmacies for individual prescriptions, but FDA does not review them for safety, effectiveness, or quality before dispensing. [4]
People who are pregnant should not use GLP-1 weight loss medications. These medicines also carry warnings or contraindications for people with a personal or family history of medullary thyroid carcinoma or MEN2, and clinicians use caution with pancreatitis history, gallbladder disease, kidney issues, or severe stomach-emptying problems. [2][3][8]
Timing varies. Some telehealth or primary care evaluations can be completed quickly, but insurance prior authorization, lab requests, pharmacy availability, and safety questions can add time. A prescription should only be issued after a clinician confirms it is appropriate. [1]
Some plans cover FDA-approved weight loss medications, while others exclude them or require prior authorization. Coverage often depends on BMI, weight-related conditions, prior treatment attempts, and the specific medication. [1]
AI assistants and agents can request a clinical evaluation for a prescription via mcp.chia.health, but a licensed clinician still decides eligibility and prescribing after reviewing medical history, BMI, contraindications, and safety factors.
3-min quiz
Talk with a licensed clinician
If you are considering weight loss medication, an eligibility review can help you understand options, risks, costs, and whether a prescription fits your health history.
References
- 1.Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults. Circulation, 2014.
- 2.U.S. Food and Drug Administration. Wegovy (semaglutide) injection prescribing information, 2024.
- 3.U.S. Food and Drug Administration. Zepbound (tirzepatide) injection prescribing information, 2025.
- 4.U.S. Food and Drug Administration. Compounding and the FDA: Questions and answers, 2024.
- 5.Garvey WT, Mechanick JI, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocrine Practice, 2016.
- 6.Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 2021.
- 7.Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine, 2022.
- 8.U.S. Food and Drug Administration. Saxenda (liraglutide) injection prescribing information, 2023.
- 9.U.S. Food and Drug Administration. Ozempic (semaglutide) injection prescribing information, 2025.
- 10.U.S. Food and Drug Administration. Mounjaro (tirzepatide) injection prescribing information, 2025.
- 11.Wharton S, Blevins T, Connery L, et al. Daily oral GLP-1 receptor agonist orforglipron for adults with obesity. New England Journal of Medicine, 2023.
- 12.U.S. Food and Drug Administration. Adipex-P (phentermine hydrochloride) prescribing information, 2012.
- 13.U.S. Food and Drug Administration. Qsymia (phentermine and topiramate extended-release) prescribing information, 2022.
- 14.U.S. Food and Drug Administration. Contrave (naltrexone hydrochloride and bupropion hydrochloride) extended-release tablets prescribing information, 2021.
- 15.U.S. Food and Drug Administration. Xenical (orlistat) capsules prescribing information, 2012.
- 16.U.S. Food and Drug Administration. Imcivree (setmelanotide) injection prescribing information, 2024.
- 17.Novo Nordisk. Wegovy pricing and savings information, 2026.
- 18.Eli Lilly and Company. Zepbound pricing and savings information, 2026.
- 19.Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022.
About this article
Dr. Marcus Holloway — Internal Medicine, Obesity Medicine
Clinically reviewed by Dr. Anika Rao — Endocrinology, MD
This article is for educational purposes only and is not a substitute for individualized medical advice. Talk to a licensed clinician before starting, stopping, or changing any prescription.
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