Semaglutide, which is available under brand names such as Ozempic® and Wegovy®, is a prescription medication that helps to achieve significant weight loss. But getting a semaglutide prescription requires meeting specific eligibility criteria.
So, how do you qualify for semaglutide? To find out, you need to go throught the following guide that breaks down the individual requirements needed to meet the eligibility.
How to Qualify for Semaglutide Medications
One thing to keep in mind: you may qualify for some versions of semaglutide but not others. This is because the U.S. Food and Drug Administration (FDA) has approved different brand-name semaglutide drugs for different uses.
Qualifying for Ozempic®
Ozempic® is FDA-approved for the treatment of type 2 diabetes. To qualify, individuals typically need to have type 2 diabetes. However, many healthcare providers may prescribe it off-label because weight loss is a beneficial side effect of the medication, making it useful for patients who meet clinical criteria for obesity treatment.
Moreover, your provider will probably look at your BMI and overall health status.
BMI Requirements to Qualify for Semaglutide
To qualify for Ozempic® for weight loss, you’ll typically need to have a:
- BMI of 30 or higher (obesity), or
- BMI of 27 or higher (overweight) with at least one weight-related health condition
Weight-related health conditions include:
- Type 2 diabetes
- High blood pressure (hypertension)
- High cholesterol (dyslipidemia)
- Obstructive sleep apnea
- Cardiovascular disease
- Heart disease
- Metabolic syndrome
Use a BMI calculator to input your current body weight and height to find out your number. But a healthcare provider will ultimately determine whether semaglutide is right for you.
Qualifying for Wegovy®
Wegovy® is FDA-approved specifically for weight loss. To qualify for Semaglutide weight loss, you’ll typically need to have a:
- BMI of 30 or higher (obesity), or
- BMI of 27 or higher (overweight) with at least one weight-related health condition
Weight-related health conditions include:
- Type 2 diabetes
- High blood pressure (hypertension)
- High cholesterol (dyslipidemia)
- Obstructive sleep apnea
- Cardiovascular disease
- Heart disease
- Metabolic syndrome
Use a BMI calculator to enter your current body weight and height to determine your BMI. But a healthcare provider will ultimately determine whether semaglutide is right for you.
Is there a compounded version of Semaglutide?
Yes, in some cases, a healthcare provider may prescribe compounded semaglutide if you have a unique need that brand-name versions can’t meet. For instance, you might need a personalized dose or an allergen removed.
Since compounded semaglutide is not FDA-approved, there are no official eligibility criteria. A healthcare provider may use Wegovy®’s prescribing guidelines to determine if compounded semaglutide is right for you. When considering compounded semaglutide for weight loss, you need to obtain it from a trusted source that requires a physician’s prescription.
Who Can’t Take Semaglutide?
Let’s say you meet the BMI requirements and are now wondering, “Can I take semaglutide?” It’s not a done deal yet. Semaglutide is safe for most people, but some people should avoid it.
You shouldn’t take semaglutide if you:
- Have a personal or family history of medullary thyroid carcinoma (MTC)
- Have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Are allergic to semaglutide or any ingredients in the medication
- Are pregnant or breastfeeding
- Have type 1 diabetes
- Are taking another semaglutide medication or another GLP-1 receptor agonist
You should also let your healthcare provider know about any medical conditions you currently have or previously had, including:
- History of pancreatitis
- Severe gastrointestinal disease or gastroparesis
- Diabetic retinopathy
- Kidney problems or kidney disease
- Gallbladder disease
- History of depression or suicidal thoughts
Tell your provider about any medication you’re on, including prescription and over-the-counter medications, vitamins, and supplements. With this information, your medical provider can let you know if semaglutide is suitable for you.
Semaglutide Qualification Process
Here’s what to expect when pursuing a semaglutide prescription:
Medical consultation: You’ll complete an online assessment or meet with a healthcare provider to discuss your weight loss goals and medical history.
BMI evaluation: Your provider will calculate your BMI using your height and weight to confirm you meet the qualification criteria.
Health assessment: Your provider will review your current medications, past medical conditions, and any weight-related health conditions you have.
Lab work (if needed): Depending on your health history, your doctor may order blood tests to check thyroid function, kidney health, and blood sugar levels.
Treatment plan: If you qualify, your provider will create a personalized plan that includes medication dosing, dietary guidance, exercise recommendations, and follow-up appointments.
Through services like Northwest Face & Body, you can often complete this process conveniently, without needing to visit a doctor’s office in person.
How Long Can You Stay on Semaglutide?
There are no official guidelines for how long you can stay on semaglutide. It depends on how your body responds to the medication and when you reach your weight-loss goals.
In general, though, you can stay on semaglutide long-term to help maintain your weight. Many people continue taking it indefinitely, while others transition off the medication after achieving their target weight.
What Results Can You Expect?
Clinical trials show that people taking semaglutide can lose approximately 15-20% of their initial body weight over 60-68 weeks when combined with lifestyle changes such as diet and exercise.
Most people notice:
- Decreased appetite within the first few weeks
- Visible weight loss after 4-8 weeks
- Maximum results after 60+ weeks of consistent use
Remember, semaglutide works best when combined with a reduced-calorie diet and regular physical activity.
Side Effects of Semaglutide
Most people experience some side effects when starting semaglutide. Here’s what to expect:
Common side effects:
- Nausea (especially in the first few weeks)
- Vomiting
- Diarrhea
- Constipation
- Abdominal pain
- Bloating
These effects typically improve over time as your body adjusts to the medication. Starting with a lower dose and gradually increasing helps minimize discomfort.
Serious but less common side effects:
- Pancreatitis
- Gallbladder problems
- Kidney complications
- Changes in blood sugar levels
- Thyroid tumors (seen in animal studies)
Contact your healthcare provider right away if you experience severe abdominal pain, persistent vomiting, or signs of pancreatitis.
Cost of Semaglutide and Insurance Coverage
One thing to keep in mind: just because you qualify for semaglutide doesn’t mean your insurance will cover it. Most insurance providers don’t cover weight loss drugs.
The costs of brand-name drugs can be high when you pick them up from your local pharmacy. Prices typically range from approximately $1,000 to $2,000 per month without insurance.
Ways to reduce costs:
- Manufacturer savings programs from Novo Nordisk
- Coupons and discounts
- Patient assistance programs
- FSA/HSA funds (weight loss medications may be eligible)
- Compounded semaglutide options (typically more affordable)
Better coverage is often available when semaglutide is prescribed for type 2 diabetes compared to weight loss alone. Some insurance plans require documentation of prior weight-loss attempts or prior authorization.
Get Started with Semaglutide at Northwest Face & Body
If you’re ready to explore semaglutide for weight loss, Northwest Face & Body offers comprehensive medical weight loss services with personalized treatment plans.
Our experienced medical team provides:
- Thorough evaluations to determine semaglutide eligibility
- Customized treatment strategies that fit your health goals
- Ongoing support and monitoring throughout your weight loss journey
- Access to multiple weight loss treatment options
We understand that each person has unique health needs and weight loss goals. Our providers take a holistic approach, combining medical treatments with lifestyle counseling to help you achieve lasting results.
Ready to see if you qualify for Semaglutide? Contact Northwest Face & Body today to schedule your consultation. We’ll evaluate your BMI, review your health history, and help you determine if this weight loss medication is right for you.
