Eligibility for GLP-1 therapy is based on a patient’s highest reported BMI. When considering if a patient is appropriate for GLP-1 treatment, we review the patient’s current BMI and historical BMI, if applicable, to help determine their treatment eligibility.
In order to qualify for GLP-1 treatment through the Text2MD patients must meet one of the following criteria:
- Current or historical BMI of 30 or higher
- Current or historical BMI of 27 – 29.9 and have one of the following medical conditions:
- Heart disease (including a heart attack 6+ months ago or history of angina without ongoing chest pain)
- Hyperlipidemia (High Cholesterol)
- Hypertension (High Blood Pressure)
- Non-alcoholic fatty liver
- Obstructive sleep apnea
- Prediabetes
- Current BMI of 23 or higher and have a history of one of the following medical procedures:
- Gastric sleeve
- Gastric bypass (Roux-en-Y)
- Currently taking a GLP-1 medication and have a current or historical BMI of 30 or higher or a current or historical BMI of 27 – 29.9 with a qualifying medical condition
*Click here to calculate your BMI
Contraindications:
- Personal or family history of medullary thyroid cancer (MTC) or in patients with multiple endocrine neoplasia (MEN) type 2
- Diabetes Type 1 or 2 (blood sugar needs to be followed serially)
- Diagnosis or history of pancreatitis
- Diagnosis or history of gastroparesis
- Known hypersensitivity to semaglutide/any other GLP-1 drug (Mounjaro, Dulaglutide, Liraglutide, tirzepatide, etc) or any of the inactive ingredients in semaglutide
Precautions to Treatment:
- Renal impairment (only in relation to volume depletion secondary to N/V/dehydration)
- Volume depletion (can worsen renal impairment)
- Females and males of reproductive potential: Discontinue semaglutide at least 2 months before a planned pregnancy because of the long half-life of semaglutide
- Pregnancy: May cause fetal harm. When pregnancy is recognized, discontinue semaglutide immediately
- Acute Pancreatitis: Has occurred in clinical trials. Discontinue promptly if pancreatitis is suspected (patient reports severe persistent abdominal pain, which may radiate to the back and may have nausea/vomiting). If suspected, patients should be instructed to receive in-person evaluation by their primary care physician or at the Emergency Room. Do not restart if pancreatitis is confirmed
- Acute Gallbladder Disease: Has occurred in clinical trials. If cholelithiasis is suspected, gallbladder studies and clinical follow-up are indicated
- Heart Rate Increase: Semaglutide can increase resting heart rate.
- Suicidal Behavior and Ideation: Monitor for depression or suicidal thoughts. Discontinue semaglutide if symptoms develop
- A recent study suggested there may be a connection between semaglutide use and increased risk for a blinding eye disease called non-arteritic anterior ischemic optic neuropathy (NAION). There isn’t enough data yet to suggest patients should be concerned or should stop taking their medications. People who have diabetes are already at risk for NAION, whether they use semaglutide or not. It is premature to conclude that the association is a causal association. More research is necessary to test the hypothesis. Until then, patients should be aware of this information and make a careful, informed choice based on their individual risk profile.
- Patients having surgery (which includes general anesthesia), the American Society of Anesthesiologists (ASA) recommends that patients taking semaglutide (compounded semaglutide, Ozempic or Wegovy) and other glucagon-like peptide-1 (GLP-1) receptor agonists stop taking the medication 1 week before elective surgery to reduce the risk of complications with anesthesia. Semaglutide may be restarted when their surgeon gives the clearance to restart. Please contact your medical provider if it has been more than 2 weeks since your last dose of medication.
