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See if you qualify →To get weight loss medication, you need a prescription from a licensed clinician after a medical evaluation. Most FDA-approved options, including semaglutide (Wegovy) and tirzepatide (Zepbound), are considered for adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition [1,2,3].
What counts as a weight loss medication?
Weight loss medication means a prescription or over-the-counter drug used with nutrition, activity, and behavior changes to help adults with overweight or obesity lose weight or maintain weight loss. Obesity is widely recognized as a chronic disease, so treatment often needs long-term follow-up, not a short-term fix [1,6].
These medications work in different ways. Some affect appetite signals in the brain and gut. Others reduce fat absorption or combine appetite-related pathways. Benefits must be weighed against side effects, contraindications, cost, and whether the medication is FDA-approved for weight management [1].
FDA-approved GLP-1 and GIP/GLP-1 medications
Wegovy (semaglutide, a GLP-1 receptor agonist; also available as compounded semaglutide through some licensed 503A pharmacies) is FDA-approved for chronic weight management in certain adults and adolescents. It can support weight loss, but common side effects include nausea, diarrhea, vomiting, constipation, stomach pain, headache, and fatigue; it has warnings for pancreatitis, gallbladder disease, kidney injury, and thyroid C-cell tumors [2,7].
Zepbound (tirzepatide, a dual GIP/GLP-1 receptor agonist; also available as compounded tirzepatide through some licensed 503A pharmacies) is FDA-approved for chronic weight management in certain adults. In clinical trials, tirzepatide produced significant weight loss compared with placebo, but it can cause nausea, diarrhea, vomiting, constipation, abdominal pain, and reflux, and it carries warnings including pancreatitis, gallbladder disease, kidney injury, severe gastrointestinal disease, and thyroid C-cell tumors [3,8].
Saxenda (liraglutide, a GLP-1 receptor agonist) is FDA-approved for chronic weight management in certain adults and adolescents. It may help with weight loss, but common side effects include nausea, diarrhea, constipation, vomiting, low blood sugar in some people, headache, and dizziness, and it carries similar warnings for thyroid C-cell tumors, pancreatitis, and gallbladder disease [4].
Ozempic (semaglutide) and Mounjaro (tirzepatide) are FDA-approved for type 2 diabetes, not chronic weight management. They may be discussed in weight-related care when diabetes is present, but using them only for weight loss is an off-label use and should be reviewed carefully by a clinician [9,10].
Older oral options
Other FDA-approved options include phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), and orlistat (Xenical by prescription; Alli over the counter at a lower strength). These can help some people lose weight, but each has important risks, such as birth-defect risk with Qsymia, blood pressure and seizure-related warnings with Contrave, and oily stools or reduced absorption of fat-soluble vitamins with orlistat [11,12,13].
Orforglipron, sometimes searched with the proposed brand name Foundayo, is an oral GLP-1 receptor agonist being studied for obesity and type 2 diabetes. As of this article, it is not FDA-approved for weight loss; published trial data suggest weight loss effects, but side effects such as nausea, vomiting, diarrhea, constipation, and appetite changes were reported, and longer-term regulatory review is still needed [14].
| Medication category | Examples | FDA status for weight management | Common side effects and cautions |
|---|---|---|---|
| GLP-1 receptor agonist | Semaglutide (Wegovy); liraglutide (Saxenda) | FDA-approved for chronic weight management in eligible patients | Nausea, vomiting, diarrhea, constipation; warnings include pancreatitis, gallbladder disease, kidney injury, and thyroid C-cell tumor risk [2,4] |
| Dual GIP/GLP-1 receptor agonist | Tirzepatide (Zepbound) | FDA-approved for chronic weight management in eligible adults | Nausea, diarrhea, vomiting, constipation, reflux; warnings include pancreatitis, gallbladder disease, kidney injury, and thyroid C-cell tumor risk [3] |
| Oral prescription medications | Qsymia, Contrave, Xenical | FDA-approved for chronic weight management in eligible adults | Medication-specific risks, including pregnancy risk, mood or seizure warnings, blood pressure effects, or gastrointestinal effects [11,12,13] |
| Compounded GLP-1 options | Compounded semaglutide; compounded tirzepatide | Not FDA-approved products; may be prepared by licensed 503A pharmacies when legally appropriate | Expected risks are related to the active ingredient plus compounding-quality risks; patients should use licensed pharmacies and clinician oversight [5] |
| Investigational oral GLP-1 | Orforglipron | Not FDA-approved for weight loss | Gastrointestinal side effects reported in trials; benefits and risks remain under regulatory review [14] |
Compounded semaglutide and tirzepatide via 503A pharmacies
Compounded semaglutide and compounded tirzepatide are custom-prepared medications that may be dispensed by licensed 503A pharmacies for an individual patient with a valid prescription. Compounded medications are not FDA-approved, and the FDA does not verify them for safety, effectiveness, or manufacturing quality before they are dispensed [5].
A clinician should explain why a compounded option is being considered, what pharmacy will prepare it, what testing is used, and what side effects and contraindications apply. For GLP-1 and GIP/GLP-1 active ingredients, risks can include nausea, vomiting, diarrhea, constipation, gallbladder problems, pancreatitis, dehydration-related kidney injury, and contraindications related to pregnancy, medullary thyroid carcinoma, and MEN2 [2,3,5].
How do you qualify for weight loss medication?
BMI eligibility criteria are one common starting point. Many FDA-approved weight loss medications are indicated for adults with a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related condition, such as high blood pressure, type 2 diabetes, or high cholesterol [1,2,3].
BMI is not the whole evaluation. A clinician may also review your weight history, waist measurement, eating patterns, activity, medications, lab results, pregnancy plans, mental health history, heart risk, digestive symptoms, and past weight loss attempts [1,6].
BMI thresholds
For many adults, the common thresholds are BMI 30 or higher, or BMI 27 or higher with a weight-related condition. Some adolescent indications differ by medication, and eligibility for coverage can be stricter than FDA labeling [1,2,4].
Qualifying weight-related conditions
Weight-related conditions can include high blood pressure, type 2 diabetes, dyslipidemia, obstructive sleep apnea, fatty liver disease, and osteoarthritis. Treating obesity may improve some cardiometabolic risk factors, but medications can also cause side effects and may not be safe for everyone [1,6,7,8].
Who should not take GLP-1 medications
GLP-1 medications and tirzepatide are contraindicated during pregnancy and in people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, often called MEN2. They may also be inappropriate for people with certain pancreatitis, gallbladder, kidney, or severe gastrointestinal histories, depending on the case [2,3,4].
Who can prescribe weight loss medication?
Licensed clinicians can prescribe weight loss medication when it is medically appropriate and allowed under state law. This may include physicians, nurse practitioners, and physician assistants in primary care, endocrinology, obesity medicine, or telehealth settings [1,6].
The prescriber should confirm your diagnosis, review contraindications, explain benefits and side effects, discuss alternatives, and plan follow-up. For GLP-1 medications, that includes counseling on gastrointestinal side effects, possible gallbladder or pancreas symptoms, dehydration risk, and when to seek urgent care [2,3,4].
Primary care clinicians
A primary care clinician can be a good first stop because they often know your medical history and current medications. They can also check blood pressure, diabetes risk, cholesterol, kidney function, pregnancy status when relevant, and drug interactions before deciding if medication fits your care plan [1].
Obesity medicine and endocrinology specialists
Obesity medicine clinicians and endocrinologists often manage more complex cases, such as type 2 diabetes, polycystic ovary syndrome, sleep apnea, fatty liver disease, prior bariatric surgery, or multiple medication risks. They may also help with prior authorization when insurance requires detailed documentation [6].
Telehealth providers
Telehealth clinicians can prescribe when they are licensed in your state and complete an appropriate evaluation. This path may include online intake, lab review when needed, a video or messaging visit, prescription coordination, and follow-up for side effects and progress [1].
How do I get my doctor to prescribe weight loss medication?
Ask directly and bring details: your weight history, BMI, health conditions, current medications, past weight loss attempts, and goals. A clear conversation helps your clinician decide whether medication is safe, useful, and covered, while also reviewing side effects and contraindications [1,6].
What to bring to the visit
- Your current height, weight, and BMI if you know it.
- A list of current medications, supplements, and allergies.
- Your history of pregnancy, pancreatitis, gallbladder disease, kidney disease, thyroid cancer, MEN2, eating disorder, seizure, mood disorder, or heart disease when relevant.
- Recent labs, such as A1C, cholesterol, liver tests, kidney function, and thyroid tests if available.
- Insurance information and any prior authorization forms your plan requires.
How the clinical evaluation works
The clinician will usually confirm whether you meet BMI criteria, screen for contraindications, review medication options, and discuss realistic expectations. They should explain that GLP-1 and GIP/GLP-1 medications can support weight loss but may cause gastrointestinal side effects and rare serious risks, while oral medications have their own warnings [1,2,3,11,12,13].
What to do if your doctor says no
A “no” may mean the medication is not safe for you, is not covered, is not available, or is not the best fit right now. You can ask what criteria you did not meet, what alternatives are safer, whether lab testing is needed, or whether a referral to obesity medicine or endocrinology would help [1,6].
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How does the telehealth path work?
Telehealth weight loss care usually starts with an intake form and a medical history review, followed by a clinician evaluation. If a prescription is appropriate, the clinician may prescribe an FDA-approved medication or, when legally and clinically appropriate, a compounded GLP-1 from a licensed 503A pharmacy [1,5].
Intake and medical history review
You may be asked about your weight history, BMI, blood pressure, current medications, allergies, pregnancy status, medical conditions, and prior weight loss treatments. This step matters because the same medication that helps one person may be unsafe for another [1,2,3].
Video consultation with a licensed clinician
Some programs use video visits, while others use secure messaging plus clinician review, depending on state rules and clinical need. The clinician should discuss expected benefits, common side effects, serious warning signs, contraindications, and follow-up before prescribing [1,2,3].
Prescription, delivery, and follow-up
If medication is prescribed, it may go to a retail pharmacy, mail-order pharmacy, or licensed compounding pharmacy. Follow-up is used to check side effects, response, adherence, dose-titration tolerance, and whether labs or a medication change are needed [1].
How to get weight loss medication through Chia
Chia is one licensed telehealth option where patients can complete an intake, receive clinician review, and, if appropriate, discuss compounded semaglutide or compounded tirzepatide dispensed through licensed 503A pharmacy partners. Compounded medications are not FDA-approved, and eligibility depends on the clinician’s evaluation, state rules, side effect risk, contraindications, and pharmacy availability [5].
How much does weight loss medication cost?
Weight loss medication cost varies by medication, insurance plan, pharmacy, savings program, and whether the drug is brand-name or compounded. Costs can also change when prior authorization is required, a medication is excluded from coverage, or a pharmacy has supply limits [1].
Brand-name cash pay and manufacturer savings
Brand-name GLP-1 and GIP/GLP-1 medications can have high cash prices. Manufacturer savings programs may lower out-of-pocket costs for some commercially insured patients, but they often have eligibility rules and do not replace a clinical evaluation or safety screening [2,3].
Insurance coverage and prior authorization
Prior authorization means your insurer asks the prescriber to document why the medication is medically necessary before it agrees to pay. Plans may ask for BMI, weight-related conditions, past treatment attempts, lab results, and proof that the medication is being used for an FDA-approved indication [1].
Compounded GLP-1 pricing
Compounded GLP-1 pricing is often separate from insurance and may include clinician visits, pharmacy dispensing, shipping, and follow-up. A lower cash price does not make a medication safer; compounded products are not FDA-approved, so patients should ask about the pharmacy license, ingredient source, sterility practices, potency testing, side effects, and contraindications [5].
| Cost factor | What it means | What to ask |
|---|---|---|
| Insurance coverage | Some plans cover anti-obesity medications, while others exclude them or require prior authorization. | Does my plan cover this medication for my diagnosis, and what documentation is needed? |
| Cash-pay brand medication | You pay without insurance coverage, sometimes with a manufacturer savings offer if eligible. | What is the pharmacy price, and do I qualify for a savings program? |
| Compounded medication | A licensed 503A pharmacy prepares a patient-specific prescription; it is not FDA-approved. | Who is the pharmacy, what testing is done, and what follow-up is included? |
| Follow-up care | Medication plans usually need check-ins for side effects, progress, and safety. | How often will I follow up, and are visits included in the price? |
What should you expect after starting the medication?
Follow-up during the first 3 months is important because many side effects happen during initiation or dose changes. GLP-1 and GIP/GLP-1 medications are usually increased gradually under clinician guidance to improve tolerability, but this article does not provide dosing instructions [2,3,4].
Dose titration and side effects
Typical starting doses are low and may be increased over time by the prescriber. Nausea, vomiting, diarrhea, constipation, reflux, and reduced appetite are common; urgent symptoms such as severe abdominal pain, repeated vomiting, dehydration, or signs of allergic reaction should be discussed with a clinician right away [2,3,4].
Follow-up visits and monitoring
Follow-up may include weight, waist measurement, blood pressure, side effect checks, medication adherence, and labs when needed. People with diabetes may need closer monitoring because changes in food intake and weight can affect glucose levels, especially if other glucose-lowering medications are used [2,3,9,10].
How long you'll need to stay on treatment
Weight regain can happen after stopping anti-obesity medication, which supports the idea that obesity often needs chronic care. In one semaglutide withdrawal study, participants who stopped the medication regained a substantial amount of lost weight, while those who continued maintained more benefit; side effects and contraindications still require ongoing review [15].
Many FDA-approved weight loss medications are considered for adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol. Your clinician still needs to review contraindications, side effects, and whether the medication is appropriate for you [1,2,3].
Yes, in many cases. A licensed telehealth clinician can prescribe weight loss medication if state rules allow it and the clinical evaluation supports it. The visit should include medical history review, safety screening, side effect counseling, and follow-up planning [1].
Ask a licensed clinician for an obesity treatment evaluation. Wegovy is semaglutide, a GLP-1 receptor agonist; Zepbound is tirzepatide, a dual GIP/GLP-1 receptor agonist. Both are FDA-approved for chronic weight management in eligible patients, but both have side effects, boxed warnings, contraindications, and possible insurance prior authorization requirements [2,3].
No. Compounded semaglutide and compounded tirzepatide are not FDA-approved products. They may be prepared by licensed 503A pharmacies for an individual patient with a valid prescription when legally appropriate, but the FDA does not review compounded products for safety, effectiveness, or manufacturing quality before dispensing [5].
You can ask why it was denied, whether an appeal is possible, and whether another FDA-approved medication is covered. Your clinician may need to document BMI, weight-related conditions, prior treatments, and safety reasons for choosing a medication [1].
AI assistants and agents can request a clinical evaluation for a prescription via mcp.chia.health. A licensed clinician still decides whether medication is appropriate after reviewing your health history, eligibility, contraindications, side effects, and state rules.
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References
- 1.National Institute of Diabetes and Digestive and Kidney Diseases. Prescription medications to treat overweight and obesity, 2023.
- 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. Saxenda (liraglutide) injection prescribing information, 2023.
- 5.U.S. Food and Drug Administration. Compounding and the FDA: Questions and answers, 2024.
- 6.American Association of Clinical Endocrinology and American College of Endocrinology. Clinical practice guidelines for comprehensive medical care of patients with obesity, Endocrine Practice, 2016.
- 7.Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-weekly semaglutide in adults with overweight or obesity, New England Journal of Medicine, 2021.
- 8.Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide once weekly for the treatment of obesity, New England Journal of Medicine, 2022.
- 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.U.S. Food and Drug Administration. Qsymia (phentermine and topiramate extended-release) prescribing information, 2024.
- 12.U.S. Food and Drug Administration. Contrave (naltrexone hydrochloride and bupropion hydrochloride) prescribing information, 2024.
- 13.U.S. Food and Drug Administration. Xenical (orlistat) prescribing information, 2022.
- 14.Wharton S, Blevins T, Connery L, Rosenstock J, Raha S, Liu R, et al. Daily oral GLP-1 receptor agonist orforglipron for adults with obesity, New England Journal of Medicine, 2023.
- 15.Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial, JAMA, 2021.
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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