GLP-1 eligibility is not one standard. FDA-approved labelling sets criteria for brand-name products, insurers apply their own rules, and telehealth providers set thresholds that range from strict clinical gates to essentially none. Understanding where a provider sits tells you a lot about how it operates.
This Is a Clinical Decision
Nothing on this page determines whether you should take a GLP-1. These medications carry real risks and contraindications, and only a licensed clinician who knows your full history can make that assessment. Treat this as background for the conversation, not a substitute for it.
The Standard Clinical Criteria
For chronic weight management, the criteria most commonly applied are a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related condition. Klinic and Heally both publish exactly this threshold.
- BMI of 30 or higher, which is classified as obesity
- BMI of 27 or higher with a weight-related condition
- Weight-related conditions typically include hypertension, type 2 diabetes, obstructive sleep apnea and high cholesterol
- Aged 18 or over at most telehealth providers
- Able to self-administer a weekly injection, for injectable formulations
Contraindications That Rule People Out
Some conditions make GLP-1 therapy inappropriate. Fridays publishes the most complete exclusion list we found among telehealth providers, and it is worth reading in full before starting anywhere.
| Contraindication | Why It Matters |
|---|---|
| Personal or family history of medullary thyroid carcinoma | A boxed warning applies to GLP-1 receptor agonists in this population |
| Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) | Also covered by the boxed warning |
| Pregnancy or breastfeeding | These medications are not appropriate during pregnancy or lactation |
| History of pancreatitis | Pancreatitis is a known potential adverse effect |
| Active eating disorder | Appetite suppression can be harmful in this context |
| Suicidal ideation | Requires separate clinical assessment before any weight medication |
| End-stage kidney or liver disease | Affects drug handling and monitoring requirements |
| Severe gastrointestinal conditions | GLP-1s slow gastric emptying, which can worsen these |
| Active cancer or organ transplant recipient | Requires specialist oversight rather than telehealth prescribing |
Compiled from provider-published exclusion criteria, primarily Fridays, Klinic and Heally. Your clinician will assess your specific situation.
How Far Provider Thresholds Vary
| Provider | Published Threshold | Notes |
|---|---|---|
| Klinic | BMI 30+, or 27+ with a condition | Publishes specific exclusions too |
| Heally | BMI 30+, or 27+ with named conditions | Also requires comfort with self-injection and cold storage |
| NexLife | Most adults with BMI 27 or higher | Framed as a guide rather than a hard gate |
| Fridays | Minimum BMI of 20 | Unusually low, but paired with detailed exclusions |
| Belle | States there are no BMI gates | Clinician review still applies |
| Medi-Weightloss | Needing to lose 10 pounds or more | In-person clinic model with physician supervision |
| Shapely | Adults 18+ in four states | Geography is the binding constraint here |
A provider advertising no BMI gates is not necessarily doing anything wrong, but it is telling you something about its model. Providers with detailed exclusion criteria and lab requirements are doing more clinical gatekeeping than those with a five-minute intake and no published thresholds.
What About Insurance Eligibility?
Insurance eligibility is a separate and usually stricter matter. Plans commonly require documented BMI, evidence of prior weight-loss attempts, and prior authorization, and many exclude weight-loss medication from coverage entirely regardless of clinical criteria. Our insurance, HSA and FSA guide covers what to expect.
Lab Work and Eligibility
Baseline labs are how a clinician confirms the picture your questionnaire describes. Fridays orders a comprehensive metabolic panel, hemoglobin A1C, TSH and a lipid panel through Quest, and accepts results from within the past 24 months. Shapely strongly recommends labs and accepts results from within 6 months. Many providers publish no lab requirement at all.
If you have not had recent metabolic bloodwork, it is reasonable to want it done before starting, whether or not your provider requires it.
Questions Worth Asking Yourself
- Do I know my current BMI and whether I have a qualifying weight-related condition?
- Do I have a personal or family history of medullary thyroid carcinoma or MEN 2?
- Have I ever had pancreatitis?
- Am I pregnant, breastfeeding, or planning pregnancy?
- Do I have a history of disordered eating that a clinician should know about?
- Have I had metabolic and thyroid labs recently, and can I share them?
- Am I comfortable with a weekly injection and refrigerated storage, or would an oral option suit me better?
Be Honest on the Intake
Telehealth intakes rely on what you tell them. Omitting a contraindication to get approved defeats the purpose of the screening and puts you at genuine risk. If a provider approves you despite something you know should exclude you, that is a reason to be more cautious about that provider, not less.
Frequently Asked Questions
What BMI do I need for a GLP-1?
The most common clinical threshold is a BMI of 30 or higher, or 27 or higher with a weight-related condition such as hypertension, type 2 diabetes, sleep apnea or high cholesterol. Telehealth providers vary widely, with Fridays publishing a minimum BMI of 20 and Belle stating it has no BMI gates.
Who should not take a GLP-1?
Published contraindications commonly include a personal or family history of medullary thyroid carcinoma, MEN 2 syndrome, pregnancy or breastfeeding, a history of pancreatitis, active eating disorder, suicidal ideation, end-stage kidney or liver disease, and severe gastrointestinal conditions. Your clinician makes this assessment.
Can I get a GLP-1 without a BMI over 30?
Many providers prescribe at a BMI of 27 or higher when a weight-related condition is present, and some publish lower or no thresholds. Whether it is clinically appropriate for you is a decision for the prescriber, not a matter of finding a provider who will say yes.
Do I need lab work to qualify?
It depends on the provider. Fridays orders a full panel through Quest and includes it; Shapely strongly recommends labs at $75 self-pay; many providers publish no lab requirement. Regardless of the requirement, baseline metabolic and thyroid testing is a reasonable thing to want.
Can I take a GLP-1 with type 2 diabetes?
GLP-1s are widely used in type 2 diabetes, and Mounjaro and Ozempic are approved for it specifically. Providers such as Heally require a type 2 diabetes diagnosis for Mounjaro. Medi-Weightloss states it can treat patients with diabetes. This needs clinician oversight, not self-assessment.
What if a provider approves me but I have a contraindication?
That is a warning sign about the provider's screening rather than a green light. Contraindications like a family history of medullary thyroid carcinoma exist because of real risk. Raise it directly with the prescriber and consider a provider that does more thorough clinical gatekeeping.
Medical Disclaimer
This article is general information, not medical advice. GLP-1 medications are prescription drugs with real risks and contraindications, and only a licensed clinician who knows your history can decide whether one is appropriate for you. Prices, programs and policies described here reflect what providers published at the time of writing and change frequently; verify everything directly before enrolling. Read our full medical disclaimer.
Last reviewed: August 24, 2026