Not everyone who wants GLP-1 treatment is a candidate for it, and no legitimate provider can tell you otherwise before reviewing your history.

Here is what actually gets assessed.

The usual starting point

Clinical criteria for weight-management use generally begin with body mass index:

BMI of 30 or above, or
BMI of 27 or above with at least one weight-related condition — type 2 diabetes, high blood pressure, high cholesterol, obstructive sleep apnoea, cardiovascular disease

BMI is a crude measure. It does not distinguish muscle from fat and performs differently across body compositions and ethnic groups. A provider treats it as a starting point rather than a verdict, alongside waist circumference, metabolic markers and your history.

You also need to be 18 or older and physically in the United States, since telehealth prescribing is regulated state by state.

What rules people out

Some history makes GLP-1 treatment inappropriate regardless of BMI:

Personal or family history of medullary thyroid carcinoma, or Multiple Endocrine Neoplasia syndrome type 2. This is a firm contraindication, based on thyroid C-cell tumours observed in rodent studies.

History of pancreatitis. Depending on cause and timing, this may rule treatment out or require particular caution.

Pregnancy, trying to conceive, or breastfeeding. These medications are not used in pregnancy, and effective contraception is typically discussed before starting.

Type 1 diabetes, or a history of diabetic ketoacidosis.

Active gallbladder disease, severe gastrointestinal conditions such as gastroparesis, or significant kidney impairment.

A history of an eating disorder. This warrants careful discussion rather than an automatic no — appetite-suppressing medication interacts with disordered eating in ways that need managing.

What needs disclosing, not hiding

People sometimes omit history they worry will disqualify them. That inverts the purpose of the review — these questions exist to keep treatment safe, and the provider is the person best placed to judge what matters.

Bring:

Every medication and supplement, including over-the-counter. Insulin and sulfonylureas in particular need dose adjustment, since combining them with a GLP-1 raises hypoglycaemia risk
Your full medical history, especially thyroid, pancreatic, gallbladder, kidney and cardiac
Family history of thyroid cancer or MEN2
Previous experience with weight-management medication and how you responded
Your mental health history, including any eating disorder

How the review works

You complete a medical intake covering the above. A licensed provider in your state reviews it and decides whether treatment is appropriate. Some states require a synchronous consultation — video or phone — before a prescription can be issued.

If treatment is appropriate, a prescription is issued and the pharmacy dispenses. If it is not, you are told why.

You should not be charged for the medication before that review. At Oria Meds the intake is free and you are charged only if a provider approves treatment. That is a reasonable standard to expect anywhere — a service that takes payment before any clinical review is not operating the way it should.

If you do not qualify

Being declined is not a dead end. Depending on the reason:

Some contraindications are temporary — pregnancy, an acute condition being treated
Some are dose or drug specific — one agent may be inappropriate while another is not
Some point to something worth investigating independently of weight

Ask what specifically ruled you out and what, if anything, would change it. A provider who declines without explanation has not done the job.

What no provider can promise

No one can guarantee you will qualify, that you will receive a prescription, or how much weight you will lose. Anyone promising otherwise before reviewing your history is selling rather than treating.

Eligibility is a clinical judgement made about you specifically — which is the point of requiring it.