The standard clinical criteria are a BMI of 30 or above, or 27 and above with at least one weight-related condition such as hypertension, prediabetes, or sleep apnea. Meeting them is the beginning of the evaluation, not the end: history, medications, and contraindications all belong to a physician's review.
Reviewed by board-certified physicians · Published 2026-08-28 · Updated 2026-08-28 · 8 min read
Key facts
The labeled criteria for the weight management GLP-1s: BMI 30+, or BMI 27+ with at least one weight-related condition.
Qualifying clinically and qualifying for insurance coverage are two different hurdles with different rules.
Absolute contraindications include a personal or family history of medullary thyroid carcinoma or MEN2, and pregnancy.
A physician can decline to prescribe even when the numbers qualify, and that judgment is the point of the evaluation.
Telehealth prescribing of these medications is legal and routine in most states when a licensed physician conducts a real evaluation.
What are the actual clinical criteria?
The FDA-approved weight management medications share the same labeled population: adults with a BMI of 30 or greater, or 27 or greater accompanied by at least one weight-related condition. The commonly counted conditions include hypertension, dyslipidemia, type 2 diabetes or prediabetes, obstructive sleep apnea, and established cardiovascular disease.
BMI is a blunt instrument, and clinicians know it. It misclassifies some muscular people upward and understates risk for some body compositions and ancestries. It persists in the criteria because it is measurable and standardized, not because it is the whole truth about metabolic risk. A physician reads the number in context; you can compute yours with our BMI calculator before the conversation.
Who should not take a GLP-1?
Some exclusions are absolute. A personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 rules these medications out under their boxed warning. Pregnancy is a hard stop, and planning a pregnancy brings a washout conversation with the physician. A history of pancreatitis, severe gastrointestinal disease such as gastroparesis, and certain eating disorder histories all demand individualized physician judgment even where the label does not flatly prohibit.
This screening is most of why a real evaluation exists. A questionnaire that cannot say no is not an evaluation, and a platform that treats the criteria as a sales checklist rather than a clinical gate is telling you what its physicians are for.
I only want to lose 15 or 20 pounds. Do I qualify?
Often not, and that is the system working. If your BMI sits below 27, the labeled criteria do not describe you regardless of how the 15 pounds feel. Between 27 and 30, the question becomes whether a qualifying condition exists, which lab work and history answer rather than instinct.
Prescribing outside the labeled population is legal for a physician but is exactly the kind of decision a careful one makes rarely and documents thoroughly. Be skeptical of any platform that treats aesthetic goals at a low BMI as a routine yes: the risk-benefit arithmetic that justifies these medications was built on the studied populations.
3/mo CHROMA23+ Membership unlocks it at one clear price, medication priced separately and always shown.
Why is insurance qualification a different question?
Insurers layer their own requirements on top of the clinical criteria: documented BMI readings, step-therapy histories, prior participation in lifestyle programs, or a plan that excludes weight loss medication entirely no matter what you document. Clinically qualifying and being covered are separate gates, which catches almost everyone off guard the first time.
If coverage is the blocker, the self-pay landscape is better than its reputation; our cost guide and denial options guide cover the realistic paths.
Do I need to have failed diet and exercise first?
The labels position these medications as an adjunct to reduced-calorie eating and increased activity, not a replacement for them, and many insurers require documented prior attempts. Clinically, a physician wants the context, what you have tried, what happened, rather than proof of suffering. There is no labeled requirement to spend another year retrying approaches that have repeatedly not held.
The medication also does not suspend the fundamentals; protein intake and resistance exercise matter more on a GLP-1, not less, a topic covered separately on this blog.
How does an online evaluation actually work?
A legitimate telehealth flow looks like this: a structured health assessment covering history, medications, and the screening questions above; identity verification; review by a physician licensed in your state, with follow-up questions or a synchronous visit where state law or clinical judgment requires it; then a prescribing decision, which can be no. State rules differ on visit modality, and a compliant platform builds those differences in rather than routing around them.
At CHROMA23®, the assessment is free and takes minutes, every prescribing decision belongs to an independent, board-certified physician licensed in your state, and nothing is charged for medication unless a physician determines treatment is appropriate. Where you live matters too: see where CHROMA23® operates.
Frequently asked questions
My primary physician will not prescribe a GLP-1. Can telehealth legitimately say yes?
Sometimes, legitimately. A declination can reflect practice policy, comfort, or coverage rather than your clinical picture, and a second physician can reach a different documented judgment. What telehealth cannot legitimately do is skip the evaluation your physician performed. If two real evaluations both say no, the answer is information, not an obstacle course.
What labs do I need before starting?
There is no universal labeled lab panel, and requirements vary by platform and clinical picture. Physicians commonly want recent metabolic context, and diabetes status particularly, since it changes both the choice of product and the monitoring. The evaluating physician tells you what they need; recent records shorten the path.
Can I qualify if I have type 2 diabetes?
Diabetes does not disqualify you; it reroutes you. The same molecules carry separate diabetes indications with their own criteria and coverage, and the physician's product choice will reflect that. Bring your medication list, since combining incretin therapies with certain diabetes drugs requires adjustment.
Is there an age limit?
The adult indications cover 18 and up. Some of these medications carry separate adolescent indications with their own criteria, which are a pediatric specialist conversation, not a telehealth checkout. Upper age has no labeled cutoff; frailty, kidney function, and polypharmacy do the deciding instead.
About CHROMA23®
CHROMA23® is a clinical weight loss platform built on prescription protocols: injectables, oral medicine, and the protocols that come next, under one 3 membership. Every prescription decision is made by an independent, board-certified physician licensed in the patient's state, and every medication is dispensed by a state-licensed pharmacy. The assessment is free. The membership is 3. The medicine is real. The physician is real.
This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Compounded medications are not FDA-approved. Always consult a board-certified physician about your individual situation. Figures from named clinical trials describe study populations; individual results vary and are not typical.