GLP-1 medicines for weight aren’t meant for everyone with a high BMI (body mass index, a measure of weight relative to height) [1, 2]. Their FDA labels spell out who they’re approved for, who shouldn’t take them, and who needs extra care [3, 4, 5, 6]. To learn how the medicines work, see GLP-1 medicines for weight: how they work.
Who the medicines are approved for
Adults
Each GLP-1 medicine approved for weight is approved for adults with obesity, or adults with overweight who also have at least one weight-related health condition [3, 4, 5, 6]. In the main studies of semaglutide (Wegovy) and tirzepatide (Zepbound), obesity meant a BMI of 30 or higher, and overweight meant a BMI of 27 to 29.9 plus at least one weight-related condition [3, 4]. Guidance from the National Institutes of Health (NIH) uses the same cutoffs: a BMI of 30 or higher, or 27 or higher with a weight-related health problem such as high blood pressure or type 2 diabetes [1].
Teens
Only Wegovy shots and liraglutide (Saxenda and its generics) are approved for teens 12 and older, and only for teens with obesity [3, 5, 7]. The Wegovy teen study enrolled teens with a BMI at or above the 95th percentile for their age and sex [3], which is how CDC defines obesity in children and teens [8]. For liraglutide, teens must also weigh more than 60 kg (about 132 pounds), with a BMI that matches an adult BMI of 30 or more by international cutoffs [5].
| Medicine | Adults | Teens 12 to 17 |
|---|---|---|
| Semaglutide shots (Wegovy) | Yes | Yes, with obesity [3] |
| Semaglutide tablets (Wegovy) | Yes | No [3] |
| Tirzepatide (Zepbound) | Yes | No [4] |
| Liraglutide (Saxenda, generics) | Yes | Yes, with obesity and a weight over 60 kg (132 pounds) [5, 7] |
| Orforglipron (Foundayo) | Yes | No [6] |
Other approved uses
Some labels include other uses with their own criteria: Wegovy for lowering the risk of heart attack and stroke in adults with cardiovascular disease and obesity or overweight, Wegovy shots for a liver disease called MASH in adults, and Zepbound for moderate to severe obstructive sleep apnea in adults with obesity [3, 4].
What BMI is, and what it misses
BMI is your weight in kilograms divided by your height in meters squared [2]. For example, an adult who is 5 feet 8 inches tall and weighs 200 pounds has a BMI of 30.4 [8]. For adults 20 and older, CDC uses these categories [9]:
- Underweight: less than 18.5
- Healthy weight: 18.5 to less than 25
- Overweight: 25 to less than 30
- Obesity: 30 or higher (40 or higher is called class 3, or severe, obesity)
Note that the studies and NIH guidance above use a BMI of 27, not 25, as the overweight cutoff for these medicines [1, 3, 4].
BMI is a quick screening tool, not a full health check. It doesn’t directly measure body fat, it can’t tell fat from muscle and bone, and it doesn’t show where fat is stored [2]. A very muscular person can have a BMI in the overweight or obesity range [8]. Waist size adds information: the National Heart, Lung, and Blood Institute considers a waist over 40 inches for men or over 35 inches for women unhealthy [10]. So CDC advises looking at BMI together with your medical history, habits, exam findings such as blood pressure, and lab results such as blood sugar and cholesterol [2].
Examples of weight-related conditions
The labels don’t list every condition that counts. The main studies included people with conditions such as [3, 4]:
- High blood pressure (hypertension)
- Unhealthy cholesterol or other blood fat levels (dyslipidemia)
- Obstructive sleep apnea, where the airway gets blocked again and again during sleep [4, 11]
- Cardiovascular disease, such as a past heart attack or stroke [3]
- Type 2 diabetes, which some studies looked at separately [1, 3, 4]
Ask your clinician whether a condition you have counts. NIH also cautions never to take a weight-management medicine only to change how you look [1].
Who should not take them
All of these labels carry a boxed warning about thyroid tumors. Semaglutide, tirzepatide and liraglutide caused thyroid C-cell tumors in rodents. Orforglipron doesn’t act on GLP-1 receptors in rats or mice and didn’t cause these tumors in them, but its label carries the same warning. It isn’t known whether these medicines cause such tumors, including a cancer called medullary thyroid carcinoma (MTC), in people [3, 4, 5, 6].
The labels say not to use these medicines if [3, 4, 5, 6]:
- You or anyone in your family has ever had MTC.
- You have multiple endocrine neoplasia syndrome type 2 (MEN 2), a condition of the endocrine (hormone) system.
- You’ve had a serious allergic reaction to the medicine or any of its ingredients.
Pregnancy. The labels say weight loss offers no benefit during pregnancy and may harm the fetus, and that the medicine should be stopped when a pregnancy is recognized [3, 4, 5, 6]. The Wegovy label says to stop at least 2 months before a planned pregnancy [3]. Pregnancy isn’t listed as a contraindication (a formal reason not to use a medicine) in the current labels; Saxenda’s label removed it in 2025 [3, 4, 5, 6]. See GLP-1 medicines, pregnancy and birth control.
Another GLP-1 medicine. The labels advise against taking two GLP-1 medicines at the same time [3, 4, 5, 6].
Who needs extra care
Some conditions don’t rule these medicines out but call for extra caution or closer follow-up. The table shows what the labels say and marks where advice is general clinical caution instead. Your clinician may also want input from a specialist, such as your diabetes care team or eye doctor.
| If you have or take | What the labels say |
|---|---|
| Past pancreatitis or other pancreas problems | Pancreatitis (an inflamed pancreas), sometimes severe or fatal, has occurred with GLP-1 medicines. The Medication Guides ask you to tell your clinician about past pancreas problems. Past pancreatitis is not listed as a reason you can’t take them [3, 4, 5, 6]. |
| Gallbladder disease | Gallstones and gallbladder inflammation happened more often with these medicines than with placebo, and fast or large weight loss can raise gallstone risk. Past gallbladder disease is not listed as a reason you can’t take them [3, 4, 5, 6]. |
| Type 1 diabetes | None of these medicines is approved to treat type 1 diabetes, and the Wegovy label says its use in people with type 1 diabetes hasn’t been studied [3, 4, 5, 6]. |
| Severe gastroparesis (very slow stomach emptying) or other severe digestive problems | Not recommended with severe gastroparesis. Tell your clinician about severe stomach or digestion problems [3, 4, 5, 6]. |
| Diabetic retinopathy (diabetes-related damage to blood vessels in the retina, at the back of the eye) | Fast improvement in blood sugar has been linked to temporary worsening, so people with a history of it should be monitored [3, 4, 6, 12]. |
| Kidney problems | Kidney injury has been reported, mostly in people who got dehydrated from vomiting or diarrhea, so clinicians may check kidney function. The Saxenda label notes limited experience in people with kidney disease [3, 4, 5, 6]. |
| Insulin or a sulfonylurea (a diabetes medicine) | Higher risk of low blood sugar. Your clinician may lower those doses and have you check your blood sugar before and during treatment [3, 4, 5, 6]. |
| Depression or past suicidal thoughts | This is not a label warning. The current Wegovy, Saxenda and Zepbound labels no longer include a warning about suicidal thoughts [3, 4, 5, 13]. The FDA asked makers to remove it in January 2026, after a review of 91 trials with 107,910 people and a large insurance-claims study found no increased risk. The FDA still advises telling your clinician about new or worsening depression, suicidal thoughts or unusual mood changes [13]. |
| An eating disorder, now or in the past | The GLP-1 labels don’t address eating disorders. General clinical caution, not label language: because these medicines lower appetite and are used with a reduced-calorie diet [3, 4, 5, 6], tell your clinician about any history of an eating disorder. |
| Surgery or a procedure with sedation coming up | Tell your care team you take a GLP-1. There have been rare reports of food from the stomach getting into the lungs during anesthesia or deep sedation [3, 4, 5, 6]. |
| Pills that need close monitoring, such as warfarin or levothyroxine (a thyroid medicine) | Slower stomach emptying may change how pills are absorbed, so your clinician may monitor them more closely. In one study, total levothyroxine exposure rose 33% with semaglutide tablets. Foundayo also interacts with some medicines through a liver enzyme called CYP3A4 [3, 4, 6]. |
What to expect at a first visit
Visits vary, so take this as a general guide. A first visit for weight care may include:
- Your health history, including current and past health problems and your family history [2]. Your clinician needs to know if anyone in your family has had MTC [3] and may ask about conditions or medicines that can cause weight gain [10].
- A review of all your medicines, including over-the-counter medicines, vitamins and supplements, and especially insulin or a sulfonylurea [1, 3].
- Questions about pregnancy plans and birth control, if you could become pregnant [3, 4].
- Measurements such as weight, height, BMI, waist size and blood pressure [2, 10]. The Wegovy and Saxenda labels also call for checking heart rate regularly [3, 5].
- Possibly blood tests, such as an A1C (your average blood sugar over the past 2 to 3 months), a metabolic panel (blood sugar, electrolytes, and kidney and liver tests) and a lipid panel (cholesterol and triglycerides) [14, 15, 16]. Your clinician may also test for conditions that can cause weight gain, such as an underactive thyroid [10]. If you have diabetes, the labels call for checking your blood sugar before you start [3, 4].
- A talk about the likely benefits, possible side effects, your other health issues and medicines, and cost [1].
Learn more in starting a GLP-1, GLP-1 side effects and GLP-1 medicine costs.
When to get medical care
- Call 911 for trouble breathing; swelling of your face, lips, tongue or throat; or chest pain or discomfort [3, 17, 18].
- If you’re taking a GLP-1 medicine, get same-day care for severe stomach pain that won’t go away, or for vomiting or diarrhea that won’t stop [3, 4].
- Tell your clinician about a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath [3, 4].
- If you have thoughts of suicide, call or text 988 [13].
The bottom line
GLP-1 medicines for weight are approved for adults with obesity, or with overweight plus a weight-related condition, and two are approved for some teens with obesity [3, 4, 5, 6]. BMI is a useful starting point but not the whole picture [2]. Don’t take them if you or a family member has had MTC, if you have MEN 2, or if you’ve had a serious allergic reaction to the medicine, and stop if you become pregnant [3, 4, 5, 6]. Several other conditions call for extra care, so share your full health history at your first visit.
References
- National Institute of Diabetes and Digestive and Kidney Diseases. Prescription Medications to Treat Overweight & Obesity. NIDDK, National Institutes of Health. 2024. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
- Centers for Disease Control and Prevention. About Body Mass Index (BMI). CDC. 2025. https://www.cdc.gov/bmi/about/index.html
- Novo Nordisk. WEGOVY (semaglutide) injection, for subcutaneous use; WEGOVY (semaglutide) tablets, for oral use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective June 18, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
- Eli Lilly and Company. ZEPBOUND (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective August 28, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
- Novo Nordisk. SAXENDA (liraglutide) injection, for subcutaneous use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective February 25, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3946d389-0926-4f77-a708-0acb8153b143
- Eli Lilly and Company. FOUNDAYO (orforglipron) tablets, for oral use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective July 29, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8ac446c5-feba-474f-a103-23facb9b5c62
- U.S. Food and Drug Administration. 2025 First Generic Drug Approvals. FDA. 2026. https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2025-first-generic-drug-approvals
- Centers for Disease Control and Prevention. BMI Frequently Asked Questions. CDC. 2024. https://www.cdc.gov/bmi/faq/index.html
- Centers for Disease Control and Prevention. Adult BMI Categories. CDC. 2024. https://www.cdc.gov/bmi/adult-calculator/bmi-categories.html
- National Heart, Lung, and Blood Institute. Overweight and Obesity – Symptoms and Diagnosis. NHLBI, National Institutes of Health. 2022. https://www.nhlbi.nih.gov/health/overweight-and-obesity/symptoms
- National Heart, Lung, and Blood Institute. Sleep Apnea – What Is Sleep Apnea? NHLBI, National Institutes of Health. 2025. https://www.nhlbi.nih.gov/health/sleep-apnea
- MedlinePlus. Diabetic Eye Problems. MedlinePlus, U.S. National Library of Medicine. 2024. https://medlineplus.gov/diabeticeyeproblems.html
- U.S. Food and Drug Administration. FDA Requests Removal of Suicidal Behavior and Ideation Warning from Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) Medications. FDA Drug Safety Communication. 2026. https://www.fda.gov/drugs/drug-safety-communications/fda-requests-removal-suicidal-behavior-and-ideation-warning-glucagon-peptide-1-receptor-agonist-glp
- MedlinePlus. Hemoglobin A1C (HbA1c) Test. MedlinePlus Medical Tests, U.S. National Library of Medicine. 2025. https://medlineplus.gov/lab-tests/hemoglobin-a1c-hba1c-test/
- MedlinePlus. Comprehensive Metabolic Panel (CMP). MedlinePlus Medical Tests, U.S. National Library of Medicine. 2023. https://medlineplus.gov/lab-tests/comprehensive-metabolic-panel-cmp/
- MedlinePlus. Cholesterol Levels. MedlinePlus Medical Tests, U.S. National Library of Medicine. 2024. https://medlineplus.gov/lab-tests/cholesterol-levels/
- MedlinePlus. Anaphylaxis. MedlinePlus, U.S. National Library of Medicine. 2025. https://medlineplus.gov/anaphylaxis.html
- Centers for Disease Control and Prevention. About Heart Attack Symptoms, Risk, and Recovery. CDC. 2024. https://www.cdc.gov/heart-disease/about/heart-attack.html
This article is for education only and isn’t a substitute for advice from your own clinician.