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BMI first, then the whole picture.
Semaglutide BMI requirements: what it takes to qualify
By the NexLife Medical Team · Medically reviewed by Adam Kennah, MD · Updated
Wegovy’s weight-loss trials enrolled adults with a BMI of 30 or more, or 27 or more with a weight-related condition; its label covers both groups (checked November 1, 2026). No FDA label covers compounded semaglutide, so a licensed provider weighs your BMI with your health history.
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- Wegovy’s trials: BMI 30 or more, or 27 with a condition
- Medicare’s Bridge: 35, or 27 to 34.9 with listed conditions
- Some health plans: prior authorization, or a BMI of 40
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Or $139/mo month to month
In the label’s range? A licensed provider reviews your full history
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| Plan | Per month | 12 months at this rate |
|---|---|---|
| 12-month Lowest monthly price | $119 | $1,428 |
| 6-month | $125 | $1,500 |
| 3-month | $132 | $1,584 |
| Month to month | $139 | $1,668 |
Month to month costs $240 more over 12 months than the 12-month plan. Plans renew until you cancel. Longer plans bill the way you choose at checkout.
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At a glance
What BMI do you need?
Six short answers from this guide, checked November 1, 2026.
| Question | Answer |
|---|---|
| Who did Wegovy’s trials enroll? | Adults with a BMI of 30 or more, or 27 to 29.9 with a weight-related condition |
| Which conditions count? | The trials named high blood pressure and high cholesterol, and studied type 2 diabetes and heart disease. Others are your provider’s call |
| Under a BMI of 27? | You’d be below every adult weight-loss trial behind Wegovy, and below Medicare’s Bridge. A careful provider may say no |
| What do insurers ask? | Often more: Medicare’s Bridge wants a BMI of 35, or 27 to 34.9 with a listed condition; some plans want prior authorization or a BMI of 40 |
| What rules you out? | Medullary thyroid cancer or MEN 2 in you or your family, a past serious allergic reaction to semaglutide, or pregnancy |
| What does NexLife charge? | $119 a month on the 12-month plan, or $139 month to month, at every dose, for compounded semaglutide, which isn’t FDA-approved |
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Key takeaways
- The BMI line: 30 or more, or 27 to 29.9 with a weight-related condition, in Wegovy’s weight-loss trials.
- Conditions in the trials: high blood pressure and high cholesterol; type 2 diabetes and heart disease were studied too.
- Payers often ask more. Medicare’s Bridge wants a BMI of 35, or 27 with a listed condition. Some plans want 40.
- Ruled out: medullary thyroid cancer or MEN 2 in you or your family, or a past serious allergic reaction to semaglutide.
- Compounded is different: it isn’t FDA-approved and has no FDA label, so a licensed provider weighs your BMI with your history.
- At NexLife, compounded semaglutide is $119 a month on the 12-month plan, or $139 month to month, at every dose.
Your BMI
Check your BMI against each line
Type in your height and weight. You’ll see your BMI, the CDC’s category for it, and how it compares with Wegovy’s label, Medicare’s Bridge and the strictest health plans.
Add your height and weight, and your BMI appears here.
The CDC’s formula: your weight in pounds, times 703, divided by your height in inches squared. The calculator runs in your browser and doesn’t save what you type.
In the label’s range? A licensed provider reviews your health history.
About 3 minutes of health questions · No insurance needed · Not prescribed? No charge for medication
Compounded semaglutide isn’t FDA-approved. A licensed provider prescribes it only when it offers a significant difference for you.
The CDC’s BMI categories
| BMI | CDC category, adults 20 and older |
|---|---|
| Under 18.5 | Underweight |
| 18.5 to under 25 | Healthy weight |
| 25 to under 30 | Overweight |
| 30 to under 35 | Obesity, class 1 |
| 35 to under 40 | Obesity, class 2 |
| 40 or more | Obesity, class 3 (severe obesity) |
Swipe the table sideways to see every column.
The CDC’s adult BMI categories, read November 1, 2026. BMI is a screening measure: the CDC says to consider it with other factors when assessing your health.
Weight at each line, by height
| Height | BMI 25 | BMI 27 | BMI 30 | BMI 35 | BMI 40 |
|---|---|---|---|---|---|
| 4 ft 11 in | 124 lb | 134 lb | 149 lb | 174 lb | 199 lb |
| 5 ft 1 in | 133 lb | 143 lb | 159 lb | 186 lb | 212 lb |
| 5 ft 3 in | 142 lb | 153 lb | 170 lb | 198 lb | 226 lb |
| 5 ft 5 in | 151 lb | 163 lb | 181 lb | 211 lb | 241 lb |
| 5 ft 7 in | 160 lb | 173 lb | 192 lb | 224 lb | 256 lb |
| 5 ft 9 in | 170 lb | 183 lb | 204 lb | 238 lb | 271 lb |
| 5 ft 11 in | 180 lb | 194 lb | 216 lb | 251 lb | 287 lb |
| 6 ft 1 in | 190 lb | 205 lb | 228 lb | 266 lb | 304 lb |
| 6 ft 3 in | 201 lb | 217 lb | 241 lb | 281 lb | 321 lb |
Swipe the table sideways to see every column.
For each height, the first whole-pound weight that crosses each BMI line, using the CDC’s formula. 25 starts overweight, 27 is the lowest BMI in Wegovy’s adult weight-loss trials, 30 starts obesity, 35 is Medicare’s top tier and 40 is the strictest plans’ line.
Step by step
How do you check if you qualify for semaglutide?
Five checks, using the lines on this page. The final say is a licensed provider’s.
Work out your BMI
Multiply your weight in pounds by 703, then divide by your height in inches squared: that’s the CDC’s formula. The calculator above does it for you.
Compare it with the trials
Wegovy’s weight-loss trials enrolled adults with a BMI of 30 or more, or 27 to 29.9 with a weight-related condition.
List your conditions
The trials named high blood pressure and high cholesterol, treated or not. Adults with type 2 diabetes or heart disease were studied from a BMI of 27.
Check what rules you out
Medullary thyroid cancer or MEN 2 in you or your family, a past serious allergic reaction to semaglutide, or pregnancy.
Let a licensed provider decide
Compounded semaglutide isn’t FDA-approved, so no label decides. A provider weighs your BMI with your whole history and prescribes it only when it offers a significant difference for you compared with an FDA-approved product.
The label
What does Wegovy’s label say about BMI?
It names two groups: adults with obesity, and adults with overweight who have at least one weight-related condition. The BMI numbers come from the trials behind it.
“To reduce excess body weight and maintain weight reduction long term in adults with obesity, or in adults with overweight in the presence of at least one weight-related comorbid condition.”
The label words it without numbers. That line is for Wegovy tablets; the weekly shot’s says the same for adults and adds ages 12 and up with obesity. In STEP 1, the largest weight-loss trial in the label, adults needed a BMI of 30 or more, or 27 to 29.9 with a weight-related condition such as treated or untreated high blood pressure or high cholesterol. No adult weight-loss trial in the label enrolled anyone with a BMI under 27.
Everything Wegovy is approved for
| Approved use | Weekly shot | Daily pill |
|---|---|---|
| Weight loss, and keeping it off | Adults with obesity, or with overweight and a weight-related condition; ages 12 and up with obesity | Adults with obesity, or with overweight and a weight-related condition |
| Lowering heart riskheart attack, stroke, heart-related death | Adults with established heart disease and obesity or overweight | The same |
| MASH, a liver diseasemoderate to advanced scarring, not cirrhosis | Adults, under accelerated approval | Not approved |
Swipe the table sideways to see every column.
From the Wegovy prescribing information (revised June 2026), read November 1, 2026. Compounded semaglutide isn’t FDA-approved for any of these uses.
Teens are measured another way. The shot’s teen trial enrolled young people 12 and older with a BMI at or above the 95th percentile for their age and sex, the CDC’s line for obesity in children and teens. The pill is for adults. This guide is about adults.
What about Ozempic? It’s semaglutide too, approved for adults with type 2 diabetes: to improve blood sugar and to lower heart and kidney risks. It isn’t approved for weight loss, so its label has no BMI line.
On tirzepatide instead? Zepbound draws its own line: see tirzepatide BMI requirements.
Conditions
Which weight-related conditions count?
The label doesn’t give a full list. Its trials named two examples and studied two more groups. Past that, it’s your provider’s judgment.
High blood pressure
Treated or untreated hypertension: one of the two examples Wegovy’s trials gave for a BMI of 27 to 29.9.
High cholesterol
Or other blood-fat problems (dyslipidemia), treated or not: the trials’ other example.
Type 2 diabetes
One trial in the label enrolled adults with type 2 diabetes from a BMI of 27. On average they lost less weight than people without diabetes, and the pill wasn’t studied for weight in type 2 diabetes.
Heart disease
A past heart attack or stroke, or peripheral artery disease. Wegovy’s heart trial enrolled adults 45 and older with one of these and a BMI of 27 or more.
Anything else
The label gives examples, not a full list. Whether another condition, such as sleep apnea or joint problems, counts is your provider’s judgment.
From the Wegovy prescribing information (revised June 2026). These trials studied FDA-approved Wegovy; compounded semaglutide wasn’t studied.
Insurers and Medicare
What do insurers and Medicare ask for?
Often more than the label. Medicare’s
Medicare’s GLP-1 Bridge
| Your BMI when you start a | What else you need |
|---|---|
| 35 or more | Nothing else: the BMI meets the line on its own |
| 30 to 34.9 | Chronic kidney disease at stage 3a or higher, uncontrolled high blood pressure, or diastolic heart failure (heart failure with preserved ejection fraction); any condition in the next row also counts |
| 27 to 29.9 | Prediabetes, a previous heart attack or stroke, or blocked arteries in the legs or arms (peripheral artery disease) with symptoms |
Swipe the table sideways to see every column.
The Bridge’s criteria as Medicare.gov lists them, read November 1, 2026. They apply to people 18 or older with Medicare drug coverage (Part D), judged at the start of
“You must be 18 or older and meet one of these requirements when you start
Medicare.gov (Centers for Medicare & Medicaid Services), Weight loss drugsGLP-1 therapy”
What the Bridge covers. Wegovy (shot or pill), Foundayo and the Zepbound KwikPen, for a $50 copay per one-month supply, from July 1, 2026 through December 31, 2027. Compounded semaglutide isn’t on the list. Your prescriber sends the prescription, completes prior authorization when asked and certifies that you’re in a diet and exercise program.
Who’s left out. Anyone whose Part D plan already pays for a
Employer and private plans
Each plan writes its own rules. GoodRx studied formulary data covering more than 190 million people, and NPR reported the results on April 22, 2026: 88% of people with
Paying cash skips the insurer, not the prescription. Novo Nordisk’s self-pay Wegovy still needs one from your provider. If your plan said no, here’s what to do when insurance won’t cover it.
Safety
What rules you out?
A few things on Wegovy’s label rule semaglutide out, and others call for a closer look. Expect your provider to ask about each.
Ruled out or not recommended
- A personal or family history of medullary thyroid carcinoma (MTC), or multiple endocrine neoplasia syndrome type 2 (MEN 2)
- A past serious allergic reaction to semaglutide or to any ingredient in the product
- Pregnancy: weight loss offers no benefit, the label says, so stop when a pregnancy is recognized, and at least 2 months before a planned one
- Severe gastroparesis (very slow stomach emptying): the label doesn’t recommend it
- Another semaglutide product or another
GLP-1 medicine at the same time: not recommended
Worth a closer look
- Pancreatitis: it’s one of the label’s warnings, so mention any past episode
- Insulin or a sulfonylurea: low blood sugar is more likely, and their dose may need to come down
- Diabetic eye disease (retinopathy): the label says to monitor people with a history of it
- Kidney problems: vomiting or diarrhea can dehydrate you, and the label asks providers to check kidney function
- Gallbladder disease: gallstones were more common on Wegovy than on placebo
- A planned surgery or procedure with anesthesia or deep sedation: tell everyone treating you
- Breastfeeding: not recommended with the Wegovy pill
The full summary is in the safety information below.
Under 27
Under a BMI of 27? The honest picture
You’d be below every adult weight-loss trial behind Wegovy, and below Medicare’s Bridge. Here’s what that means.
- 25 to 26.9 counts as overweight on the CDC’s scale, and the label’s overweight group has no number. But no adult weight-loss trial in Wegovy’s label enrolled anyone with a BMI under 27, so the trial evidence doesn’t include you.
- Under 25 isn’t overweight. The CDC calls 18.5 to under 25 a healthy weight, outside both groups the label covers.
- Coverage rules start higher. Medicare’s Bridge begins at 27, and some private plans ask for 40.
- A careful provider may say no, and that protects you. Answer the health questions honestly: they’re how a provider keeps you safe.
- Walk away from a seller that skips the review. The FDA lists a company that doesn’t require a screening and prescription by a licensed doctor as a telehealth red flag.
At NexLife
How does NexLife decide?
With a licensed provider’s review of your whole history, not a box you tick. Here’s what happens.
A 3-minute health assessment
Online questions about your height, weight, health conditions, medicines and history.
A provider weighs it all
A licensed provider looks at your BMI with everything else, and prescribes compounded semaglutide only if it’s right for you and offers a significant difference for you.
No prescription, no charge
If a provider says no, there’s no charge for medication.
If you are prescribed
$119 a month on the 12-month plan, $125 on 6 months, $132 on 3 months or $139 month to month, at every dose. That covers your provider, a nutrition plan, a 1:1 coaching call and free expedited shipping.
“Compounded drugs should only be used in patients whose medical needs cannot be met by an FDA-approved drug.”
U.S. Food and Drug Administration, Compounding and the FDA: Questions and Answers
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Vial math
How many units is your semaglutide dose?
It depends on your vial’s strength. Here are the Wegovy label’s dose steps at two example strengths.
| Weeks | Weekly dose | At 2.5 mg/mL | At 5 mg/mL |
|---|---|---|---|
| 1 to 4 | 0.25 mg | 0.1 mL (10 units) | 0.05 mL (5 units) |
| 5 to 8 | 0.5 mg | 0.2 mL (20 units) | 0.1 mL (10 units) |
| 9 to 12 | 1 mg | 0.4 mL (40 units) | 0.2 mL (20 units) |
| 13 to 16 | 1.7 mg | 0.68 mL (68 units) | 0.34 mL (34 units) |
| 17 onward | 2.4 mg | 0.96 mL (96 units) | 0.48 mL (48 units) |
The math: mL = dose ÷ strength (mg per mL); units = mL × 100. At 2.5 mg/mL, 1 mg is 1 ÷ 2.5 = 0.4 mL, or 40 units. At 5 mg/mL, the same 1 mg is 0.2 mL, or 20 units.
Both strengths are examples only. The same dose is a different number of units at a different strength, so read the strength on your own vial’s label. Your prescription sets your dose and schedule, which may differ from these label steps. If your label’s units differ from this chart, follow the label and ask your pharmacy. Every step: the semaglutide dosage chart.
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Semaglutide
Weekly
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Compounded, not FDA-approved. A licensed provider prescribes it only when it offers a significant difference for you. Vials shown are illustrations. Always use the strength on your pharmacy’s label. Every plan and price · Price Match Guarantee† terms
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Semaglutide eligibility: your questions
Fair questions about NexLife
- Will my price go up with my dose?
- No. You pay the same at every dose.
- What if I’m not prescribed?
- You aren’t charged for medication.
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- Yes, by email. It takes effect 30 days after we receive it. Plans renew until you cancel; our cancellation policy has the details.
- Do I need insurance?
- No. Pay with an HSA or FSA card, or with Affirm, Klarna or Afterpay at checkout.
What BMI do you need for semaglutide?
Wegovy’s weight-loss trials enrolled adults with a BMI of 30 or more, or 27 or more with a weight-related condition; its label covers both groups. The conditions its trials named include treated or untreated high blood pressure and high cholesterol. No FDA label covers compounded semaglutide, so a licensed provider weighs your BMI with your health history.
Can I get semaglutide with a BMI of 27?
Possibly. A BMI of 27 to 29.9 is in the overweight range, and Wegovy’s label covers overweight when you also have a weight-related condition, such as high blood pressure or high cholesterol. Without one, you’re outside the label’s groups. A provider reviews your history before deciding.
Can I get semaglutide with a BMI of 25?
It’s less likely, and it’s a provider’s call. A BMI of 25 to 26.9 counts as overweight, but no adult weight-loss trial in Wegovy’s label enrolled anyone with a BMI under 27, and Medicare’s Bridge starts at 27 too. A careful provider may say no, and that protects you.
Which conditions count with a BMI of 27 to 29.9?
Wegovy’s trials named treated or untreated high blood pressure and high cholesterol, and the label’s trials also enrolled adults with type 2 diabetes or heart disease from a BMI of 27. Other conditions are your provider’s judgment. Bring a list of your diagnoses and medicines to your assessment.
Does Ozempic have a BMI requirement?
No. Ozempic is approved for adults with type 2 diabetes, to improve blood sugar and to lower heart and kidney risks, not for weight loss, so its label has no BMI line. Wegovy is the semaglutide brand approved for weight. Compounded semaglutide isn’t FDA-approved for either use.
What does Medicare’s GLP-1 Bridge require?
Part D, 18 or older, and a BMI of 35 or more when you start, or 30 with diastolic heart failure, uncontrolled high blood pressure or stage 3a+ kidney disease, or 27 with prediabetes, prior heart attack or stroke, or symptomatic peripheral artery disease. Wegovy is $50 a month with prior authorization through December 31, 2027; compounded semaglutide isn’t covered.
Will I lose eligibility after I lose weight?
Not on the label: Wegovy is approved to reduce excess weight and to keep it off long term, so a lower BMI doesn’t end treatment by itself. Medicare’s Bridge looks at your BMI when you start a
What rules you out of semaglutide?
A personal or family history of medullary thyroid carcinoma or MEN 2, a past serious allergic reaction to semaglutide, and pregnancy; the label says to stop at least 2 months before a planned pregnancy. It isn’t recommended with severe gastroparesis or with another
How do I calculate my BMI?
Multiply your weight in pounds by 703, then divide by your height in inches squared: that’s the CDC’s formula. At 5 feet 7 inches, you cross a BMI of 27 at 173 pounds and 30 at 192 pounds.
How does NexLife decide if I qualify?
It comes down to a licensed provider’s review of about 3 minutes of online health questions: your BMI, conditions, medicines and history. You’re prescribed compounded semaglutide only when it’s right for you, and there’s no charge for medication if you’re not.
Important safety information
Compounded tirzepatide and semaglutide are not FDA-approved, and the FDA hasn’t reviewed them for safety, effectiveness or quality. A provider prescribes them only when they offer a significant difference for you compared with an FDA-approved product. Both medicines may cause thyroid tumors, including cancer: don’t use either if you or a family member has had medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).
Read the full safety information
In studies with rodents, both medicines caused thyroid tumors; it isn’t known whether they cause them in people. Tell your provider if you notice a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath. Serious side effects can include inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems from dehydration, severe stomach problems, serious allergic reactions, vision changes in people with type 2 diabetes, and a faster heart rate. Tell your care team before any surgery or procedure that uses anesthesia or deep sedation. Don’t combine either medicine with other
Tirzepatide can make birth control pills less effective: switch to a non-oral method, or add a barrier method such as condoms, for 4 weeks after you start and for 4 weeks after each dose increase. Both medicines may harm an unborn baby. Semaglutide should be stopped at least 2 months before a planned pregnancy. Tell your provider right away if you’re pregnant, planning to be, or breastfeeding.
This is a summary, not the complete safety information. Read the full Prescribing Information for FDA-approved tirzepatide (Zepbound) and semaglutide (Wegovy), and talk with your provider. You can report side effects to the FDA at
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About NexLife. NexLife is a telehealth and care-coordination platform. Care is delivered through affiliated, physician-owned medical groups, and licensed providers decide whether treatment is right for you. NexLife doesn’t make or compound medication: state-licensed partner pharmacies fill each prescription, and we coordinate the rest. Available only in states where our affiliated providers are licensed.
Who wrote and checked this page
Leads the NexLife Medical Team, which writes and medically reviews NexLife’s guides, including this one.
Wegovy and Ozempic labels, Medicare.gov, CMS and the CDC read November 1, 2026; NPR’s report, October 27, 2026.
- How we checked. The label’s groups, its trials’ BMI lines, the warnings and the teen line come from the Wegovy prescribing information (revised June 2026), and Ozempic’s uses from its own prescribing information (revised May 2026); we read both on November 1, 2026, with the STEP 1 abstract. Medicare’s rules come from Medicare.gov and CMS, and the BMI formula and categories from the CDC, all read November 1, 2026. The 88% figure is GoodRx’s, from NPR’s report of April 22, 2026, re-read October 27, 2026. The weights come from the CDC formula. This page doesn’t decide who qualifies; a licensed provider does.
- Every fact, sourced. Each price and rule links to the page it comes from.
- How we make money. NexLife is a telehealth and care-coordination platform. We earn revenue when people join NexLife.
- Corrections, fast. See something wrong or out of date? Email care@nexlife.us and we’ll fix it.
Paying less elsewhere? We match it.†
You know the line. Next: a 3-minute check.
Answer a few health questions online, and a licensed provider weighs your BMI with the rest of your history. Compounded semaglutide is $119 a month on the 12-month plan, or $139 month to month, at every dose.
4.8 out of 5 on Trustpilot · Medical director Adam Kennah, MD (NPI 1144260043) · LegitScript-certified
Compounded medications aren’t FDA-approved. A provider prescribes one only when it offers a significant difference for you.
- 1Tell us about you
Start online with your health history.
- 2A licensed provider decides
Online, or by secure video where your state requires a live visit. You’re prescribed only if treatment is right for you.
- 3We ship it, then stay with you
Our partner pharmacy usually ships within 1 to 2 business days. Free shipping, and questions come to us 24/7, never to the pharmacy.
Sources
- Wegovy (semaglutide) injection and tablets, prescribing information, Novo Nordisk (revised June 2026). Read November 1, 2026.
- Ozempic (semaglutide) injection, prescribing information, Novo Nordisk (revised May 2026). Read November 1, 2026.
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). N Engl J Med 2021;384:989-1002, abstract. Read November 1, 2026.
- Medicare.gov: Weight loss drugs (the Medicare
GLP-1 Bridge). Read November 1, 2026. - CMS: Medicare
GLP-1 Bridge, overview and FAQs. Read November 1, 2026. - NPR: Restrictions on obesity drug coverage force patients to pivot (April 22, 2026). Read October 27, 2026.
- CDC: Adult BMI categories. Read November 1, 2026.
- CDC: BMI frequently asked questions (the formula). Read November 1, 2026.
- FDA: concerns with unapproved
GLP-1 drugs used for weight loss (telehealth red flags). Read November 1, 2026. - NexLife: pricing, every plan.
- U.S. Food and Drug Administration. Compounding and the FDA: Questions and Answers. Content current as of September 16, 2025; read November 2, 2026.
- Eli Lilly and Company, via Drugs@FDA. ZEPBOUND (tirzepatide) injection, for subcutaneous use: prescribing information, revised 02/2026. Read November 2, 2026.
- U.S. Food and Drug Administration. MedWatch: The FDA Safety Information and Adverse Event Reporting Program. Read November 2, 2026.
- U.S. Food and Drug Administration. FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize. Content current as of April 1, 2026; read November 2, 2026.