Am I a candidate for Wegovy or Zepbound?

FDA candidacy criteria for Wegovy and Zepbound

Both Wegovy (semaglutide) and Zepbound (tirzepatide) are FDA-approved for chronic weight management in adults who meet specific criteria:

BMI of 30 or higher (obesity)
If your BMI is 30 or above, you may qualify for GLP-1 medication as part of a structured weight management plan that includes reduced-calorie diet and increased physical activity.

BMI of 27 or higher with at least one weight-related comorbidity
If your BMI is between 27 and 29.9, you may qualify if you have at least one of the following conditions:

• Type 2 diabetes
• High blood pressure (hypertension)
• High cholesterol or triglycerides (dyslipidemia)
• Obstructive sleep apnea
• Cardiovascular disease

These are FDA criteria. Insurance plans may have additional requirements, such as documented lifestyle modification efforts or step-therapy protocols requiring you to try other medications first. At PEAK, we handle these requirements and manage prior authorization submissions for you.

What the clinical evaluation includes

At PEAK, candidacy is determined through a face-to-face consultation with a clinician. This is not a questionnaire you fill out online. It's a medical evaluation.

Health history review

Your clinician will review your medical history, including:

• Current medications (to check for contraindications or interactions)
• Previous weight loss attempts and results
• History of eating disorders or disordered eating patterns
• Thyroid function and hormone health
• Gastrointestinal conditions (GERD, gastroparesis, pancreatitis history)
• Mental health history and current wellbeing

Physical examination

Your initial visit includes a physical exam, baseline vital signs (blood pressure, heart rate), and body composition analysis using a Styku 3D body scan. This gives your clinician a detailed picture of your muscle mass, body fat percentage, and metabolic health—not just your weight.

Lab work

Baseline labs are ordered to assess thyroid function, kidney function, liver enzymes, lipid panel, hemoglobin A1C, and other metabolic markers. This ensures there are no underlying conditions that would make GLP-1 therapy unsafe or ineffective.

Goal-setting conversation

Your clinician will ask about your weight loss goals, your motivations, and what success looks like to you. This is where realistic expectations are established. If you're hoping to lose 50 pounds in 3 months, your clinician will help you understand what's clinically realistic—and what's not.

Setting realistic expectations

Clinical trials show average weight loss of approximately 15% with Wegovy (68 weeks) and up to 22.5% with Zepbound (72 weeks), when combined with lifestyle modifications. But "average" means some patients lose more, and some lose less. Individual results depend on adherence, metabolic response, nutrition, physical activity, sleep, stress, and genetics.

Here's what GLP-1 medications do well:

• Reduce appetite and food-focused thoughts
• Slow gastric emptying, helping you feel full longer
• Improve insulin sensitivity and glycemic control
• Support sustained weight loss when combined with behavioral changes

Here's what they don't do:

• Replace the need for nutrition and exercise changes
• Work the same way for every patient
• Guarantee a specific amount of weight loss
• Eliminate the need for ongoing medical oversight

At PEAK, we're transparent about this from the first visit. If you're looking for a prescription-only solution, GLP-1 therapy probably isn't the right fit. If you're ready to pair medication with real behavior change, we can help you build a plan that works.

Who is not a candidate for GLP-1 medications

Certain conditions make GLP-1 medications inappropriate or unsafe. Your clinician will not prescribe Wegovy or Zepbound if you have:

• A personal or family history of medullary thyroid carcinoma (MTC)
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• A history of severe pancreatitis
• Active gallbladder disease or recent cholecystitis
• Severe gastroparesis or significant gastrointestinal motility disorders
• Pregnancy or plans to become pregnant (GLP-1 medications must be discontinued at least 2 months before conception)
• Active eating disorder or history of disordered eating that has not been addressed

Additionally, if your BMI does not meet FDA criteria and you do not have documented weight-related comorbidities, your clinician will not prescribe GLP-1 medications for weight loss. This is not gatekeeping—it's practicing within FDA-approved indications and insurance coverage rules.

Your next step

If you think you may be a candidate, the next step is a consultation. At PEAK, that means:

1. Submit your information through our online form.
2. Our team reviews your information and verifies your insurance within one business day.
3. We call you to schedule your first in-person visit at our Chesapeake office.
4. You meet with a clinician who evaluates your health history, orders labs, and discusses whether GLP-1 therapy is appropriate for you.
5. If you’re a candidate, we submit prior authorization to your insurance and begin your treatment plan.

No pressure. No obligation. Just a real conversation with a real clinician who will tell you honestly whether GLP-1 therapy makes sense for your situation.

The PEAK Clinical Team

PEAK Wellness & Aesthetics

Evidence-based guidance from our board-certified clinicians specializing in medical weight loss and obesity medicine.