GLP-1 medications such as semaglutide and tirzepatide have changed how weight is managed medically, and many people now ask whether they qualify. The answer depends on published eligibility criteria, on a short list of conditions that rule these medications out, and on baseline information about your health. This article covers all three.
What these medications do
GLP-1 is a hormone that the gut releases after eating. It signals fullness to the brain and slows the emptying of the stomach. It also helps the pancreas release insulin when blood sugar rises. Semaglutide is a long-acting medication that activates the GLP-1 receptor. Tirzepatide activates both the GLP-1 receptor and the receptor for a second gut hormone called GIP. Both medications reduce appetite, and most people who take them eat less as a result.
Who qualifies
The FDA prescribing information for the weight-management versions of these medications describes the adults they are intended for. Those adults have a body mass index (BMI) of 30 or higher, or a BMI of 27 or higher together with at least one weight-related condition. Common weight-related conditions include high blood pressure, type 2 diabetes, high cholesterol and obstructive sleep apnea. These medications are meant to be used together with changes in diet and physical activity, not in place of them.
Meeting these criteria makes a person eligible for a conversation. It does not mean that a prescription is automatically appropriate. A licensed provider weighs your full history before deciding.
Who should not take them
The labels list conditions that rule these medications out entirely. A person should not take semaglutide or tirzepatide if they or a family member has had medullary thyroid carcinoma, a rare type of thyroid cancer. The same applies to anyone with multiple endocrine neoplasia syndrome type 2 (MEN2), an inherited condition that predisposes to that cancer. A prior serious allergic reaction to the medication is also a reason not to take it. These medications are not recommended during pregnancy, and anyone who is pregnant, planning a pregnancy or breastfeeding should raise this with a provider before starting.
Several other conditions do not automatically rule a person out but call for a careful discussion. They include a history of pancreatitis, gallbladder disease, kidney disease and diabetic eye disease in people with type 2 diabetes. People who take insulin or a sulfonylurea for diabetes face a higher risk of low blood sugar, so a provider may need to adjust those medications. Anyone with a planned surgery or procedure should tell the surgical team, because the labels warn about a risk of inhaling stomach contents during anesthesia or deep sedation.
The baseline labs and what each one tells your provider
A careful intake usually includes blood work. Lab reference ranges differ between laboratories, and no single number on these tests decides eligibility by itself. Your provider interprets each result against your own history.
Blood sugar and hemoglobin A1c
Fasting glucose and hemoglobin A1c show whether you have normal blood sugar, prediabetes or diabetes. This matters for two reasons. It establishes a starting point, and it tells your provider whether other diabetes medications may need to change to avoid low blood sugar.
Lipid panel, including triglycerides
A lipid panel measures cholesterol and triglycerides. Very high triglycerides are a recognized cause of acute pancreatitis, and the risk increases with the triglyceride level. A provider will want to know this before prescribing a medication whose label lists pancreatitis as a warning.
Kidney function
Kidney function is usually measured with creatinine and an estimated glomerular filtration rate (eGFR). The main kidney concern with these medications is dehydration. Nausea, vomiting, diarrhea and poor fluid intake can lead to dehydration, and the labels report acute kidney injury in that setting, including in people with existing kidney disease. A baseline result lets your provider recognize a change later.
Liver function
Liver tests such as ALT and AST give a baseline measure of liver health. Fatty liver disease is common in people with excess weight, and knowing your starting point helps your provider interpret any later change.
Pancreatic enzymes and thyroid tests in specific situations
Routine testing of the pancreatic enzymes lipase and amylase is not required for everyone. Some providers order them for people with a history of pancreatitis or unexplained abdominal symptoms. Similarly, thyroid function tests are not required for everyone, but a provider may order them if you take thyroid medication or have symptoms of a thyroid problem.
What follow-up looks like
After treatment begins, your provider decides how often to check in and which tests to repeat. Follow-up usually focuses on side effects, blood sugar in people with diabetes, and any new symptoms. Severe abdominal pain, persistent vomiting, yellowing of the skin or eyes, or signs of dehydration call for prompt medical attention.
Where Truthe fits
The Truthe Rx LEAN program is a physician-prescribed weight-loss program for adults that offers semaglutide or tirzepatide. If you and a licensed provider decide that a GLP-1 medication belongs in your plan, the program begins with a provider-led intake that reviews your history before you start. Truthe does not prescribe, and surgeons do not prescribe through Truthe. An independent licensed provider decides whether a prescription is appropriate for you.
Disclaimer: This content is for educational purposes only and is not medical advice. Consult a licensed healthcare provider to determine whether GLP-1 therapy is appropriate for you.
Sources
- U.S. Food and Drug Administration. Wegovy (semaglutide) injection, prescribing information: indications, contraindications, and warnings and precautions. dailymed.nlm.nih.gov
- U.S. Food and Drug Administration. Zepbound (tirzepatide) injection, prescribing information: indications, contraindications, and warnings and precautions. dailymed.nlm.nih.gov
- Garg R, Rustagi T. Management of hypertriglyceridemia induced acute pancreatitis. Biomed Res Int. 2018;2018:4721357. PMID 30148167. doi.org/10.1155/2018/4721357
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