Who Is Eligible for Ozempic? Your Guide to Getting Prescription GLP-1s
With benefits beyond diabetes and weight loss, here's how you can start to figure out if you're eligible for a GLP-1 like semaglutide
When the medications were developed, only people with diabetes could get a prescription for injectable GLP-1 medications. This specific class of medications help the body produce more insulin, and therefore, control blood sugar levels. However, since 2014 GLP-1s have been approved as an obesity treatment, with more and more evidence that GLP-1 medications are beneficial for more than just diabetes and weight loss. Now, the challenge for some people is just figuring out: Who is eligible for Ozempic?
“Identifying the right candidates is crucial to ensure the safe and effective use of GLP-1s,” Dr. Supatra Tovar, RD, tells Woman’s World. “These medications may come with side effects such as gastrointestinal disturbances, pancreatitis, and thyroid tumors, particularly in certain high-risk populations. By targeting individuals who stand to benefit the most, healthcare providers can maximize the benefits while minimizing potential risks.”
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Individuals with a high BMI are more likely to be eligible for GLP-1s
If you have a certain BMI (body mass index), doctors may consider eligible for a semaglutide prescription. BMI is a number that’s based on someone’s weight in relation to their height. And those who have a BMI of at least 30, which is “obese,” tend to be easily eligible for a GLP-1 prescription. Those with a BMI up to 27 may also be eligible if they experience at least one “weight-related” ailment. This can include anything from cardiovascular disease to high blood pressure, high cholesterol or even chest pain.
“BMI is not a perfect measure for evaluating health and there is no one size that fits all ideal weight,” Elizabeth Huggins, RDN, of Hilton Head Health Wellness Resort & Spa says. “But, studies have found that a BMI higher than 25 increases one’s risk for heart disease, type two diabetes, and some forms of cancer. Researchers continue to refine the best, most accurate ways to evaluate who should be eligible to use GLP1 medications.”
Most type 2 diabetes patients are eligible
The GLP-1 helps the body produce more insulin and maintain healthy blood sugar levels, which often makes people with diabetes eligible for GLP-1 prescriptions. However, if you have type-1 diabetes, it’s a different story: “These medications are designed primarily for people with type 2 diabetes, where they help regulate insulin and blood sugar levels,” Dr. Tovar says. “GLP-1s are not recommended for individuals with type 1 diabetes, as these patients require insulin therapy rather than medications that enhance insulin secretion .”
GLP-1s are not recommended for individuals with type 1 diabetes, as these patients require insulin therapy rather than medications that enhance insulin secretion.
People with certain health risks aren't eligible for GLP-1s
Even with a high BMI, not everyone is eligible for Ozempic and semaglutide or tirzepatide medications. Specifically, patients with certain health and family health histories may not qualify: “Individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 should avoid GLP-1 medications,” Dr. Tovar says. “Pregnant or breastfeeding women are also advised against using these medications, as are those with severe gastrointestinal diseases like gastroparesis or a history of pancreatitis .”
Extensive screening before taking Ozempic is crucial
Because health and family history is so important, Huggins reiterates that careful screening is important before starting medications like Wegovy or Ozempic: “People respond to medicines differently, so clear and thorough communication with one’s health care professional is very important to make sure a GLP1 medication are safe for the user,” she explains.
“Websites for the FDA approved GLP-1 medications have detailed lists describing safety information. Gastrointestinal side effects are common and can range from mild to severe and even life threatening. Other dangerous side effects include inflammation of the pancreas, serious allergic reactions, severe stomach problems, dehydration, changes in vision, gallbladder problems, kidney problems.”
It's dangerous for people who aren't overweight to take Ozempic
Even though you may see celebrities who never appeared to be overweight allegedly taking GLP-1s, it isn’t necessarily safe. Dr. Tovar says there are various unnecessary risks in taking drugs like Ozempic if you don’t have that BMI of 27 or more: “Since GLP-1s are intended for those who are overweight or obese, using these medications in individuals with lower BMIs may lead to unnecessary risks without significant benefits,” she explains. “Potential side effects like nausea, pancreatitis, and hypoglycemia could outweigh the benefits in individuals who are not overweight.”
Potential side effects like nausea, pancreatitis, and hypoglycemia could outweigh the benefits in individuals who are not overweight.
Those with a past of eating disorders should also refrain from taking GLP-1s
Nutrition and a healthy mindset is key while taking these medications, so people who under-eat, or have a past with eating disorders, should talk to their doctor about whether they should stay away from Ozempic, Wegovy or other GLP-1s. “It cannot be overstated that there are significant concerns for people with a current or past history of eating disorders and/or disordered eating as it may reignite or exacerbate symptoms,” Dr. Tovar adds. “There is also an overall danger for anyone taking these medications without proper nutrition, especially if caloric intake is too low, as is often the case with those on these medications.”
GLP-1s like Ozempic also have age restrictions, for both seniors and younger people
Even though many older individuals may seek out GLP-1s to make losing weight easier, it may not always be safe. Dr. Tovar says these kinds of medications can provide older folks with numerous potential health risks: “There are concerns with older adults, especially those over 75, who may be more prone to side effects like dehydration and gastrointestinal issues,” Dr. Tovar tells us. “In such cases, lower doses are often useful to monitor tolerance. There are [also] significant concerns for younger populations as they have specific nutritional needs.”
Some telehealth providers may prescribe GLP-1s without the same testing
There are many telehealth providers that are willing to simply discuss your family history and goals. Some companies, like Remote Pharmacy and Henry Meds, do not necessarily require testing or in-person appointments. Dr. Tovar advises that you opt for a telehealth pharmacy that provides necessary screening and monitoring, to ensure you’re losing weight successfully and healthily.
“Proper patient screening and monitoring remain crucial due to potential risks ,” Dr. Tovar explains. “The rise of compounding pharmacies offering under-regulated and easily accessible knock-offs of brand named semaglutide medications poses significant dangers. This can include inconsistent dosing, potential contamination, and lack of oversight. This can increase the risk of adverse health outcomes for consumers.”
Eligibility for Ozempic is strict not only for health reasons, but also due to high demand
Because GLP-1s are in high demand right now, it’s also important that pharmacies closely vet those who are eligible so that ultimately, it’s the people who need it for diabetes can still access it. “FDA-approved manufacturers have taken a stance that these medications should be prescribed accordingly. They should also be used in conjunction with healthy diet and exercise,” Huggins tells us. “Improperly prescribed medications can be dangerous. High demand has also led to shortages and disruptions in availability for those who might need it the most.”
Insurance won't always cover GLP-1s for weight loss
Most insurance companies will cover drugs like Ozempic for diabetes. However, not all of them will cover GLP-1s for weight loss. Depending on your plan, they may only cover people with a specific BMI or health ailments. And they might not cover them for weight loss at all. But telehealth providers such as those previously mentioned offer generic “compounded GLP-1s” for a lower price. That means they are more affordable than paying hundreds — or even thousands — of dollars for name brands out-of-pocket.
“Insurance may not cover GLP-1s for weight loss if they aren’t medically unnecessary. This means for individuals without significant comorbidities,” Dr. Tovar says. “Insurers may also be reluctant due to the high cost of these medications. They might to limit coverage to patients with more severe health conditions, such as diabetes or established cardiovascular risks .”
Eligibility for Ozempic is largely based on your health history
Whether or not you’re eligible for Ozempic and other GLP-1s is mostly contingent on your health history. Most peolle with diabetes or a BMI of at least 30 can easily get a prescription, but those with lower BMIs compounded with co-morbidities can get them, too. Testing is important in case of other health issues, though, and anyone under the BMI limit or with a history of eating disorders should also refrain without a close consultation with and supervision from a doctor.
FAQs
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Are GLP-1s safe for everyone?
Those who aren't overweight shouldn't take GLP-1s. Also, older folks — and those with health concerns — should speak to a doctor.
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Why is it so hard to get a GLP-1 prescription?
GLP-1s aren't safe for everyone, depending on your health condition. And because it's in such high demand, they are rationed.
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Do GLP-1s always facilitate weight loss?
GLP-1s often result in weight loss. But those who don't qualify may not need them.
