GLP-1 Eligibility: Who Actually Qualifies?
Most GLP-1 telehealth providers never publish their eligibility criteria — you find out after completing an intake. Here is what the criteria generally are, what rules you out entirely, and how to read a provider that keeps its requirements hidden.
Common BMI Floor
27+
With Comorbidity
BMI 27–29
Without Comorbidity
Usually BMI 30+
Decision Made By
Licensed provider
The Standard Criteria
GLP-1 medications for chronic weight management are generally prescribed along a well-established framework. Most providers work from some version of it, even when they do not publish the details.
24hrdoc is one of the few providers to publish its criteria outright, and its list is representative of the market: a BMI of 27+ with a related condition such as type 2 diabetes or high blood pressure, no personal or family history of medullary thyroid carcinoma, not currently pregnant or breastfeeding, and a willingness to make lifestyle changes alongside the medication.
The usual BMI framework
| Your BMI | Typically eligible? | Condition |
|---|---|---|
| 30 or above | Usually yes | Obesity — generally qualifies on BMI alone |
| 27–29.9 | Often yes | Requires a weight-related comorbidity |
| 25–26.9 | Sometimes | Varies by provider; often declined |
| Under 25 | Usually no | Generally outside labeled use for weight management |
What counts as a weight-related comorbidity
Commonly accepted conditions include type 2 diabetes, prediabetes, high blood pressure, high cholesterol, obstructive sleep apnea, cardiovascular disease, and fatty liver disease. If you have one of these and a BMI in the 27–29.9 range, you will often qualify where you otherwise would not.
What Usually Rules You Out
Some factors are absolute contraindications and some are relative — meaning a clinician weighs them rather than automatically declining you. These are the ones that come up most often.
Generally absolute
- ✗Personal or family history of medullary thyroid carcinoma (MTC)
- ✗Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- ✗Current pregnancy, or actively trying to conceive
- ✗Breastfeeding
- ✗Known serious hypersensitivity to the medication or its components
Requires careful clinical judgment
- •History of pancreatitis
- •Gallbladder disease or history of gallstones
- •Severe gastrointestinal disease, including gastroparesis
- •History of an eating disorder
- •Significant kidney impairment
- •Diabetic retinopathy
- •Type 1 diabetes
- •Concurrent use of other medications affecting blood sugar, including insulin or sulfonylureas
Be complete on your intake form, even if it costs you the prescription
The screening questions exist because these interactions carry real risk. Omitting a history of pancreatitis, an eating disorder or a family history of thyroid cancer to get approved puts you in genuine danger, and an async telehealth review has no other way to catch it. Answer honestly.
What Providers Actually Check
Eligibility screening varies enormously across the market, and the depth of the check is a reasonable signal of how seriously a provider takes clinical safety.
| Screening depth | What it looks like | Examples |
|---|---|---|
| Minimal | Short async questionnaire, no video visit | Coby Health (~3 min), 24hrdoc (~10 min) |
| Moderate | Longer intake, async provider review, optional labs | Most compounded telehealth providers |
| Thorough | Live video visit with a clinician, lab review | Calibrate (20-min visit incl. lab review) |
| Clinician-led | You book a real visit with a named doctor | Sesame, Doctronic |
A three-minute questionnaire is convenient, and for a healthy patient with a straightforward history it may be perfectly adequate. But if your history is complicated — prior pancreatitis, GI disease, an eating disorder, or multiple medications — the async model has less opportunity to catch problems. In that situation, paying for a program with a live clinician visit is a reasonable investment.
Will You Need Bloodwork?
This is the single most under-disclosed detail in the market. Of the providers we reviewed, most do not publish their lab requirements at all — meaning you cannot tell before enrolling whether bloodwork will be required, offered, or skipped entirely.
Calibrate is the clearest exception: its 20-minute clinician visit explicitly includes lab work review, though it states lab tests themselves are not included in the membership cost and are billed under your insurance. Alan Meds offers optional lab testing across 40+ biomarkers as a personalization feature.
Labs are not strictly required to prescribe a GLP-1, but they can be genuinely useful — establishing a baseline A1C, checking kidney and liver function, and screening for thyroid issues before you start. If lab-informed care matters to you, ask directly, because the public sites usually will not tell you.
Geographic Eligibility Is Real — And Rarely Advertised
Even if you meet every clinical criterion, you may not be eligible where you live. Telehealth prescribing and compounded medication rules vary by state, and providers restrict their footprints accordingly.
Coby Health is unusually upfront, stating it serves most states and metro areas except Arkansas, Louisiana, Mississippi and New Mexico. Doctronic states it operates in all 50 states plus DC. Most other providers we reviewed — including Ro Body, ShedRx, 24hrdoc, ScriptsMD and Invigor Medical — do not publish state availability on their public pages at all.
Check this before you pay, not after
Confirm your state is served before entering payment details. Providers that keep a $50 non-refundable clinical fee — as Coby Health does — will charge it even if the outcome is that they cannot serve you.
What to Do If You Don't Qualify
Being declined by one provider does not mean GLP-1 therapy is off the table, and it does not mean nothing can help. Here is how to proceed.
Find out why
Ask the provider for the specific reason. A BMI just under threshold, a missing comorbidity diagnosis, and an absolute contraindication are very different situations with very different next steps.
If it's a contraindication, take it seriously
A decline for medullary thyroid carcinoma history, MEN 2, pregnancy or pancreatitis history is a genuine safety decision. Do not shop for a provider with looser screening — find a different treatment approach with your own doctor.
If it's borderline BMI, get properly assessed
An undiagnosed comorbidity — prediabetes, sleep apnea, hypertension, high cholesterol — can move you from ineligible to eligible. See a primary care physician for actual testing rather than self-reporting on an intake form.
Ask about non-GLP-1 options
Several providers carry alternatives. ShedRx offers naltrexone/bupropion and metformin combinations; ScriptsMD offers liraglutide and metformin; Invigor Medical offers LDN. These may suit patients who do not qualify for or tolerate a GLP-1.
Consider a clinician-led route
If your case is complex, a real consultation — Sesame from $34, Doctronic at $39, or your own primary care physician — will get you a more considered assessment than an async form.
Frequently Asked Questions
What BMI do I need to qualify for a GLP-1?
Most providers work from a BMI of 30 or above, or 27 or above with a weight-related condition such as type 2 diabetes, high blood pressure, high cholesterol or sleep apnea. 24hrdoc publishes exactly this: a BMI of 27+ with a related condition. Below 27, most providers will decline.
What automatically disqualifies me from a GLP-1?
The generally absolute contraindications are a personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2, pregnancy or actively trying to conceive, breastfeeding, and known serious hypersensitivity to the medication. History of pancreatitis, gallbladder disease, gastroparesis and eating disorders require careful clinical judgment rather than automatic exclusion.
Do I need blood tests before starting a GLP-1?
Not always. Most telehealth providers do not publish their lab requirements at all, and many prescribe without bloodwork. Calibrate includes lab work review in its clinician visit, and Alan Meds offers optional testing across 40+ biomarkers. Baseline labs are not mandatory but can be clinically useful — ask your provider directly.
Can I get a GLP-1 if I'm not diabetic?
Yes. GLP-1 medications are prescribed for chronic weight management as well as type 2 diabetes. You would typically need a BMI of 30+, or 27+ with a weight-related condition, and a licensed provider must determine the medication is appropriate for you.
What if I'm declined by one telehealth provider?
Ask why first. If it is an absolute contraindication, treat that as a genuine safety finding rather than shopping for looser screening. If it is a borderline BMI, getting properly assessed by a primary care physician may identify an undiagnosed comorbidity that changes your eligibility. Non-GLP-1 alternatives also exist at several providers.
Does where I live affect my eligibility?
Yes. Telehealth prescribing and compounded medication rules vary by state. Coby Health, for example, states it cannot serve Arkansas, Louisiana, Mississippi or New Mexico, while Doctronic operates in all 50 states plus DC. Most providers do not publish state availability, so confirm before paying.
Should I be completely honest on the intake form?
Yes, without exception. The screening questions exist because these conditions carry real interaction risks, and an asynchronous review has no other way to detect them. Omitting a relevant history to secure a prescription puts you at genuine risk.
Medical disclaimer: This article is for general information only and is not medical advice, a diagnosis, or a treatment recommendation. Eligibility criteria described here are general patterns observed across providers, not clinical guidance for your situation. Only a licensed healthcare professional who knows your full medical history can determine whether a GLP-1 medication is appropriate for you.
Disclosure: This article may contain affiliate links. If you sign up through our links, we may receive a commission at no additional cost to you. This does not influence our editorial recommendations.
Think You Might Qualify?
Compare the providers that publish their eligibility criteria up front — and see which ones make you guess.