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Am I eligible for a GLP-1? What each label actually says — and what programs add on top

By the US Health Digest editorial team · Published August 28, 2026 · Updated September 2, 2026 · Every claim linked to its primary source

At label level, the four FDA-approved GLP-1 brands for weight management share one eligibility sentence: they are indicated, alongside a reduced-calorie diet and increased physical activity, for adults “with obesity or adults with overweight in the presence of at least one weight-related comorbid condition” (Zepbound, Foundayo, and in near-identical wording Wegovy and Saxenda). The number most people expect — BMI 30, or 27 with a comorbidity — appears in none of those four Indications and Usage sections; it sits further down, in the Clinical Studies sections describing who was enrolled in the trials. All four are contraindicated in anyone with a personal or family history of medullary thyroid carcinoma (MTC) or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and in anyone with a prior serious hypersensitivity to the drug or its excipients; only two carry an adolescent indication, both from age 12 and both for obesity only. Whether you qualify is a clinical judgement no web page can make.

Two related pages sit either side of this one: what happens at a GLP-1 “medical review” covers the evaluation itself, and GLP-1 insurance coverage in 2026 what plans pay for.

The threshold that is no longer in the indication

Zepbound's Section 1 states the indication, in full, as: “ZEPBOUND is indicated in combination with a reduced-calorie diet and increased physical activity: to reduce excess body weight and maintain weight reduction long term in adults with obesity or adults with overweight in the presence of at least one weight-related comorbid condition. to treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity.” The only other text in Section 1 is the Limitations of Use line below. No kilograms per square metre anywhere. Wegovy, Foundayo and Saxenda are the same: “obesity” and “overweight” are used undefined. The only numbers in any of those four Section 1s are ages — 12 years and older, on Wegovy injection and Saxenda — and Saxenda's floor of “body weight greater than 60 kg” for adolescents. No BMI figure appears in any of them.

The familiar numbers live in Section 14, which describes trial entry criteria. Zepbound's Study 1 enrolled “adult patients with obesity (BMI ≥30 kg/m²), or with overweight (BMI 27 to <30 kg/m²) and at least one weight-related comorbid condition, such as dyslipidemia, hypertension, obstructive sleep apnea, or cardiovascular disease”; Foundayo's Trial 1 used the same sentence. Wegovy's and Saxenda's equivalent sections use BMI ≥30, or 27–29.9 with “at least one weight-related comorbid condition such as treated or untreated dyslipidemia or hypertension”. Note the “such as”: these are illustrative descriptions of a trial population, not a legal test. Which conditions count is decided by the prescriber, and then, separately, by whoever is paying.

Label eligibility at a glance

Ozempic and Mounjaro are the same molecules as Wegovy and Zepbound under different approvals, and neither label carries a weight-management indication. Prescribing them for weight loss is off-label — lawful for a physician, but outside what FDA reviewed. One caution on names: since April 27, 2026 the Ozempic name has also been on an oral semaglutide tablet, which shares a single DailyMed label with Rybelsus (SPL v14, August 19, 2026, under Rybelsus's NDA 213051). Those tablets are indicated only for glycemic control in adults with type 2 diabetes and for reducing major adverse cardiovascular events in adults with type 2 diabetes who are at high risk for them; they carry no weight-management indication and no pediatric indication. So “Ozempic” now names two products, an injection and a tablet, and neither is approved for weight management. The oral semaglutide that is approved for weight management is Wegovy tablets, a separate label. Eligibility is only the first question: for what the trials found once you are eligible, see our Wegovy vs Zepbound comparison and, for the two pills, oral Wegovy vs Foundayo.

The limitations of use, and the hard stops

All four weight-management labels carry a Limitations of Use line restricting combination with other GLP-1s. Wegovy's reads: “Concomitant use of WEGOVY (semaglutide) tablets or WEGOVY (semaglutide) injection with other semaglutide-containing products or with any other GLP-1 receptor agonist is not recommended.” Foundayo's is one line: “Concomitant use with another GLP-1 receptor agonist is not recommended.” Zepbound's and Saxenda's say the same of their own molecules; Saxenda adds that its safety and effectiveness “in pediatric patients with type 2 diabetes have not been established.”

The Contraindications sections are short and identical in substance. Zepbound's, in full: “ZEPBOUND is contraindicated in patients with: A personal or family history of MTC or in patients with MEN 2 [see Warnings and Precautions (5.1)]. Known serious hypersensitivity to tirzepatide or any of the excipients in ZEPBOUND. Serious hypersensitivity reactions, including anaphylaxis and angioedema, have been reported with tirzepatide.” Wegovy's, Foundayo's and Saxenda's differ only in the molecule named. Note what is not there: pregnancy appears in Section 4 of none of the four. It sits in Use in Specific Populations instead, where Zepbound says “Weight loss offers no benefit to a pregnant patient and may cause fetal harm” and Wegovy directs prescribers to “discontinue WEGOVY in patients at least 2 months before they plan to become pregnant to account for the long half-life of semaglutide.” See our pregnancy and fertility explainer.

What programs add on top — these are the program's rules, not the FDA's

The label is the floor. Whoever pays sets a second, usually higher, bar. Three named payer examples follow, each from that body's own published document and none generalisable to the others, and then what telehealth programs themselves publish.

Medicare's GLP-1 Bridge

CMS's provider page for the Medicare GLP-1 Bridge (last modified August 6, 2026) requires a prescriber attestation covering two things. First, that the drug is prescribed to reduce or maintain weight “in combination with current and ongoing lifestyle modification including structured nutrition and physical activity consistent with the applicable FDA approved label.” Second, that the beneficiary is at least 18 and has “a BMI greater than or equal to thirty-five (≥35) at the time of initiation of GLP-1 therapy,” or BMI ≥30 with heart failure with preserved ejection fraction, uncontrolled hypertension, or chronic kidney disease stage 3a or above, or BMI ≥27 with pre-diabetes, previous myocardial infarction, previous stroke, or symptomatic peripheral artery disease. That is a narrower and more numeric test than any label, and it runs the other way too: CMS states that beneficiaries with type 2 diabetes, moderate-to-severe OSA or MASH “are ineligible to receive them through the Medicare GLP-1 Bridge, even if they otherwise meet the Medicare GLP-1 Bridge clinical criteria,” because those indications are covered by Part D. CMS also states, in answer to whether a prescriber can appeal a prior-authorization denial, that “There is no appeals process under Medicare GLP-1 Bridge” — though it adds that a prescriber “may resubmit the prior authorization form if they initially entered incorrect information or have updated or additional information to include.” See our Bridge explainer.

One state Medicaid program: Washington Apple Health

Washington's Health Care Authority publishes its semaglutide criteria as medical policy 61.25.20.AA-4, effective February 1, 2026. Its position on weight loss is one sentence: “Semaglutide injection or tablet (Wegovy®) is not covered by Apple Health for weight loss”, citing the federal statutory exclusion at 42 U.S.C. 1396r–8(d)(2)(A). Wegovy is covered there only for cardiovascular risk reduction or MASH, and that pathway adds criteria the label does not: BMI ≥27, age ≥18, established cardiovascular disease from a defined list, concurrent secondary-prevention therapy, and — pointedly — that the “patient does not have diabetes or HgA1C > 6.5%.” The revision history shows how fast these rules move: the version effective December 1, 2025 “removed lifestyle requirements” and “removed requirement for waist circumference.” This is Washington's rule only; other states differ.

Employer plans

KFF's 2025 Employer Health Benefits Survey found that among firms offering health benefits with 200 or more workers, 16% of those with 200–999 workers, 30% of those with 1,000–4,999 and 43% of those with 5,000 or more cover GLP-1 agonists when used primarily for weight loss. Of those 200-plus-worker firms that do cover them: “Thirty-four percent of firms covering these drugs for weight loss require enrollees to meet with a dietitian, case manager, or therapist, or participate in a lifestyle program in order to receive the coverage.” That is a condition no label imposes.

Telehealth programs

We checked the public program pages of three telehealth companies on August 28, 2026 — Ro, Noom Med and WeightWatchers — and none of the three publishes its own numeric BMI threshold, comorbidity list, lab panel or age minimum as a program eligibility rule on that page. Noom's page does carry BMI numbers, but in a footnote describing who was enrolled in the Wegovy and Zepbound trials — “patients without diabetes and with BMI >= 30, or BMI >= 27 with a weight-related condition” — not as Noom's own criterion. Each of the three routes the eligibility question to an intake questionnaire and a clinician review; WeightWatchers' page says only “Take a quick online quiz about your health history to see if you are a potential fit for the program.” We are not saying such criteria do not exist — only that they were not published on those three pages on that date, so a prospective patient cannot compare them before applying. We did not complete any intake questionnaire or search the rest of these companies' sites. Our program comparison covers how these companies operate.

Disqualifiers that surprise people

• A relative's thyroid cancer. The contraindication is a personal or family history of MTC, so a healthy person with an affected parent or sibling is contraindicated on all six labels.
• Already being on a GLP-1. The Limitations of Use lines mean stacking two GLP-1 products — including a semaglutide product plus a tirzepatide product — is not recommended on any of the four.
• Severe gastroparesis. Wegovy, Zepbound, Foundayo and Saxenda all state the drug “is not recommended in patients with severe gastroparesis.”
• Being a teenager on the wrong product. Among the branded products only Wegovy injection and Saxenda carry adolescent indications; Saxenda also requires body weight above 60 kg. Generic liraglutide injection referencing Saxenda carries the identical wording, adolescent bullet included (for example Teva's liraglutide injection label), so the brand name on the pen is not what decides this. Wegovy tablets, Zepbound and Foundayo have none — see our teens and young adults report.
• Having a qualifying diagnosis. Under the Medicare Bridge, a type 2 diabetes, OSA or MASH diagnosis moves you out of the program into Part D; under Washington Apple Health's policy an A1c above 6.5% blocks the cardiovascular pathway.
• What is not a labeled contraindication. Prior pancreatitis, gallbladder disease and pregnancy do not appear in Section 4 of any of these labels. They sit in warnings and population-specific instructions instead — a different, clinician-judged category.

Why BMI is a weak criterion in the first place

The 2025 Lancet Diabetes & Endocrinology Commission on clinical obesity — 58 experts, Rubino and colleagues, Lancet Diabetes Endocrinol 2025;13(3):221–262 — puts it directly: “Current BMI-based measures of obesity can both underestimate and overestimate adiposity and provide inadequate information about health at the individual level.” Its recommendation is that “BMI should be used only as a surrogate measure of health risk at a population level, for epidemiological studies, or for screening purposes, rather than as an individual measure of health,” with excess adiposity confirmed by direct body-fat measurement or at least one additional anthropometric criterion such as waist circumference or waist-to-height ratio — except above BMI 40, where it says excess adiposity “can pragmatically be assumed.” None of this changes any FDA label or payer rule. It is simply the strongest published argument that a single number is a poor gate.

Questions for your prescriber

• Which product are you considering, and what does its label indicate it for — weight management, cardiovascular risk reduction, sleep apnea, MASH, or diabetes?
• If my BMI is in the 27–30 range, which weight-related condition of mine are you counting, and is it documented in my chart?
• Do I or any blood relative have a history of medullary thyroid carcinoma or MEN 2?
• Am I on any other GLP-1 receptor agonist, including a compounded one?
• Do I have severe gastroparesis or another severe gastrointestinal condition?
• If I could become pregnant: how far in advance of a planned pregnancy would the drug need to stop, and what contraception counselling applies to this product?
• Whose criteria am I being measured against — the FDA label, my plan's prior-authorization policy, or this program's internal rules? May I see them in writing?
• If I am denied, what is the appeals route, and is there one at all?

If a denial is where you land, our guide to appealing a GLP-1 coverage denial sets out the steps.

Common questions

Does the FDA label say I need a BMI of 30, or 27 with a comorbidity?

Not in the indication itself. The current Indications and Usage sections for Wegovy, Zepbound, Foundayo and Saxenda use the words obesity and overweight without any numeric BMI cut-off. The BMI 30, or 27 to under 30 with a comorbidity, figures appear in the Clinical Studies sections describing who was enrolled in the pivotal trials, and are used in practice by prescribers and payers rather than being written into the indication.

Are Ozempic and Mounjaro approved for weight loss?

No. Two different labels now carry the Ozempic name. The Ozempic injection label indicates it for glycemic control in adults with type 2 diabetes, for reducing major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and for kidney and cardiovascular outcomes in type 2 diabetes with chronic kidney disease. Ozempic oral semaglutide tablets share a label with Rybelsus and are indicated for glycemic control in adults with type 2 diabetes and for reducing major adverse cardiovascular events in adults with type 2 diabetes who are at high risk for them. As of its current Structured Product Label, version 38 published May 6, 2026, Mounjaro's label indicates it as an adjunct to diet and exercise to improve glycemic control in people aged 10 and older with type 2 diabetes. On August 28, 2026 the FDA approved Mounjaro to lower the risk of major adverse cardiovascular events in adults with type 2 diabetes who are at high risk for those events, on the SURPASS-CVOT trial, but that approval has not yet reached the published label: we downloaded the full v38 Structured Product Label from DailyMed again on September 2, 2026 and it contains no occurrence of MACE, major adverse, SURPASS-CVOT or dulaglutide. None of the three carries a weight-management indication, so using any of them for weight loss is off-label.

The August 28, 2026 cardiovascular approval, the SURPASS-CVOT result behind it and the gap between an approval and a revised label are covered in Mounjaro’s cardiovascular indication.

This page describes published criteria. It does not tell any reader whether they personally qualify for a medication, and nothing here is a recommendation to start, stop or change any treatment. Those decisions belong with a licensed clinician who knows your history.

Sources

1. DailyMed. WEGOVY (semaglutide) injection and tablet — current Structured Product Label, version 19, published June 30, 2026. Link.
2. DailyMed. ZEPBOUND (tirzepatide) injection — current SPL, version 38, published May 6, 2026. Link.
3. DailyMed. FOUNDAYO (orforglipron) tablet — current SPL, version 10, published August 13, 2026. Link.
4. DailyMed. SAXENDA (liraglutide) injection — current SPL, version 22, published June 15, 2026. Link.
5. DailyMed. OZEMPIC (semaglutide) injection — current SPL, version 20, published June 10, 2026. Link.
6. DailyMed. MOUNJARO (tirzepatide) injection — current SPL, version 38, published May 6, 2026. Link.
7. DailyMed. OZEMPIC (oral semaglutide) tablet / RYBELSUS (oral semaglutide) tablet — combined SPL, version 14, published August 19, 2026 (NDA 213051; Ozempic-branded tablets marketed from April 27, 2026). Link.
8. DailyMed. LIRAGLUTIDE injection, solution [Teva Pharmaceuticals, Inc.] — generic referencing SAXENDA, checked August 28, 2026. Link.
9. Centers for Medicare & Medicaid Services. Medicare GLP-1 Bridge — Information for Providers; clinical criteria and eligibility FAQs, page last modified August 6, 2026. Link.
10. Washington State Health Care Authority. Anorexiants/Anti-Obesity: GLP-1 Receptor Agonists — Wegovy (semaglutide), medical policy 61.25.20.AA-4, effective February 1, 2026. PDF.
11. KFF. 2025 Employer Health Benefits Survey — GLP-1 coverage by firm size and conditions attached to coverage. Link.
12. Rubino F, Cummings DE, Eckel RH, et al. Definition and diagnostic criteria of clinical obesity. Lancet Diabetes Endocrinol. 2025;13(3):221–262. PMID 39824205.
13. Eli Lilly and Company. FDA approves Lilly’s Mounjaro (tirzepatide) to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes, August 28, 2026 — source for the approval date, the indication wording, and the SURPASS-CVOT figures (N=13,299; active comparator dulaglutide 1.5 mg; hazard ratio 0.92, 95.3% CI 0.83–1.01; non-inferiority met, superiority to dulaglutide not established). Link.
14. Ro. Weight loss program page, checked August 28, 2026. Link.
15. Noom Med. Program page, checked August 28, 2026. Link.
16. WeightWatchers. Weight-loss medication program page, checked August 28, 2026. Link.