Getting a Wegovy prescription starts with meeting specific medical criteria and walking into your appointment prepared to discuss them. Doctors can’t prescribe it to anyone who simply wants to lose weight. You need to fall within FDA-approved eligibility thresholds, bring documentation of your weight history, and in most cases, satisfy your insurance company’s requirements before a prescription moves forward.
Who Qualifies for Wegovy
The FDA approved Wegovy for three groups of people. The first is adults with obesity, defined as a BMI of 30 or higher. The second is adults with a BMI between 27 and 29.9 who also have at least one weight-related health condition, such as high blood pressure, high cholesterol, type 2 diabetes, or sleep apnea. The third is adolescents aged 12 and older whose BMI falls at or above the 95th percentile for their age and sex.
Wegovy also carries a separate approval for adults with established cardiovascular disease (a prior heart attack, stroke, or peripheral artery disease) who have a BMI of 27 or above. If you fall into this category, the prescription aim is reducing the risk of future cardiovascular events, not just weight loss.
If you don’t meet any of these criteria, your doctor will not be able to prescribe it. BMI is the gatekeeper, so know yours before your appointment. You can calculate it by dividing your weight in pounds by your height in inches squared, then multiplying by 703, or just use any free online BMI calculator.
What to Bring to Your Appointment
Doctors assess whether medication is appropriate based on how long you’ve carried excess weight, what you’ve already tried, and what other health conditions are in the picture. The more specific you can be, the smoother the conversation. Before your visit, write down the following:
- Your weight history: the age you first became overweight, your highest and lowest adult weights, and the weight you’ve been able to maintain most comfortably.
- Previous weight loss attempts: every diet program, calorie-tracking period, exercise routine, or supervised plan you’ve tried, along with how long you stuck with it and what happened.
- Past weight loss medications: anything from phentermine to orlistat to herbal supplements. Include how long you took each one and whether it worked.
- Weight-related health conditions: diabetes, high blood pressure, high cholesterol, sleep apnea, polycystic ovarian syndrome, or joint problems linked to your weight.
- Current exercise and eating habits: whether you track calories, how often you exercise, and what a typical week looks like. This shows you’re already engaged in the lifestyle component that Wegovy is designed to complement.
This documentation matters because Wegovy is FDA-approved specifically “in combination with a reduced calorie diet and increased physical activity.” Your doctor needs to see that you’re committed to both, not looking for a standalone fix.
How to Frame the Conversation
Many people feel awkward asking for a specific medication by name, but doctors are used to it. The key is framing your request around your health goals rather than the drug itself. Start by telling your doctor that managing your weight has been a long-term challenge, that you’ve tried specific approaches without lasting success, and that you’d like to discuss whether a GLP-1 medication could help.
If your doctor seems hesitant, ask direct questions: “Do I meet the clinical criteria for Wegovy?” and “If not this medication, what would you recommend instead?” Some primary care doctors are less experienced with newer weight management drugs and may refer you to an obesity medicine specialist or endocrinologist. That referral isn’t a rejection. Specialists often have more streamlined processes for prescribing and handling insurance paperwork.
One thing that helps: don’t minimize your struggles. If your weight is affecting your sleep, your energy, your joints, or your blood sugar, say so clearly. These are the weight-related comorbidities that make you eligible, and your doctor needs them documented in your chart.
Lab Work Your Doctor Will Order
Before prescribing Wegovy, your doctor will run baseline blood tests to make sure the medication is safe for you and to establish a starting point for monitoring. Expect tests for fasting blood sugar and HbA1c (a three-month average of blood sugar levels), kidney function, liver function, thyroid levels, a complete cholesterol panel, and a complete blood count. These aren’t obstacles to getting the prescription. They’re standard safety checks that also help document the weight-related health conditions supporting your eligibility.
Who Cannot Take Wegovy
Certain conditions rule out a Wegovy prescription entirely. You cannot take it if you or a blood relative has had medullary thyroid carcinoma, a rare type of thyroid cancer. It’s also contraindicated if you have a condition called Multiple Endocrine Neoplasia syndrome type 2. And if you’ve had a serious allergic reaction to semaglutide (the active ingredient in both Wegovy and Ozempic), it’s off the table.
Pregnancy is another firm disqualifier. If you’re pregnant or planning to become pregnant soon, these medications should not be used. Your doctor will likely ask about this before prescribing.
Navigating Insurance Coverage
Even with a prescription in hand, insurance is often the biggest hurdle. Most commercial plans require prior authorization, which means your doctor’s office submits paperwork proving you meet specific criteria before the insurer agrees to pay. This process can take days to weeks.
What insurers typically want to see varies by plan, but major carriers like UnitedHealthcare have detailed requirements. For the cardiovascular risk reduction indication, they require documented evidence of a prior heart attack, stroke, or peripheral artery disease, plus proof that you’re already on standard heart medications like a statin and blood pressure drugs. For weight management alone, many plans require documentation of BMI, weight-related conditions, and sometimes evidence that you’ve participated in a structured diet or exercise program for a set period, often three to six months.
Some plans still exclude weight loss medications entirely. If your insurer denies coverage, ask your doctor’s office to file an appeal. You can also check Novo Nordisk’s patient assistance programs, which sometimes offer savings cards or temporary coverage bridges. Be aware that without insurance, Wegovy’s retail price runs over $1,300 per month, so understanding your coverage situation early saves time and frustration.
If Wegovy Isn’t an Option
If you can’t get Wegovy due to insurance denial, supply shortages, or a medical contraindication, alternatives exist. Zepbound (tirzepatide) has identical BMI eligibility thresholds: a BMI of 30 or higher, or 27 or higher with a weight-related condition. It works through a dual mechanism, activating both GLP-1 and a second hormone pathway called GIP, compared to Wegovy’s single GLP-1 pathway. Clinical data suggests tirzepatide produces slightly greater average weight loss, though individual results vary. Zepbound carries the same thyroid cancer and pregnancy contraindications.
Ozempic uses the same active ingredient as Wegovy (semaglutide) but is approved for type 2 diabetes, not weight management. Some doctors prescribe it off-label for weight loss, though insurance is less likely to cover it for that purpose. Other options include older medications like phentermine-topiramate or naltrexone-bupropion, which produce more modest weight loss but may be easier to access.
What to Expect After the Prescription
Wegovy is a once-weekly injection you give yourself at home using a prefilled pen. The dose starts low and increases gradually over 16 to 20 weeks to reduce side effects, mainly nausea. The medication works by activating receptors in your brain that regulate hunger and fullness, reducing appetite so you naturally eat less. It also slows how quickly food leaves your stomach, which keeps you feeling satisfied longer after meals.
In the pivotal 68-week clinical trial of nearly 2,000 adults, participants on Wegovy lost significantly more weight than those on placebo. But results depend heavily on maintaining the diet and activity changes alongside the medication. If you stop taking it without having built sustainable habits, weight regain is common. Your doctor will likely schedule follow-up visits every few months to check your progress, repeat lab work, and adjust your plan.