Who qualifies for Ozempic vs. Wegovy? See BMI rules, age limits, PCOS/OB-GYN off-label use, and who can prescribe—then book a telehealth intake.

If your ears perk up when you hear about weight-loss medications, you’re likely also wondering, “Who qualifies for Ozempic?” The Food and Drug Administration (FDA) currently approves Ozempic for the treatment of type 2 diabetes. But another drug similar to Ozempic is approved for weight loss and management. That drug is called Wegovy.

Wegovy and Ozempic rely on the same active ingredient, semaglutide. In this guide, we’ll explore who qualifies for Ozempic for weight loss and Wegovy eligibility. Then, you’ll get insight into who can prescribe Ozempic and a bit about insurance coverage. Let’s get started!

Who Qualifies for Ozempic vs. Wegovy?

Who qualifies for Ozempic? Ozempic is FDA-approved for adults living with type 2 diabetes and helps reduce the risk of cardiovascular events. But it’s not yet approved for weight loss. Instead, it works to:

• Help manage blood sugar levels
• Helps lower the risk of heart and circulatory problems
• Helps lower the risk of kidney disease and failure

Wegovy is FDA-approved for chronic weight management. Your doctor will prescribe it for adults with a BMI of 27-30. If a BMI is less than 30, clinicians expect a comorbid condition to be present to qualify. Comorbidities include:

• High blood pressure
• Type 2 diabetes
• High cholesterol

Teens aged 12 years and older may also qualify for Wegovy if their BMI is at or above the 95th percentile for age and sex. Wegovy eligibility is more than just your weight and health history. You’ll also need to eat a healthy diet and stay active to reach your goals. 

Who Can Prescribe Ozempic vs. Wegovy

Licensed physicians, MD or DO, can prescribe Ozempic and Wegovy, and this includes OB-GYN specialists. If you’re wondering, “Can a gynecologist prescribe Ozempic for PCOS?” the answer is yes, as long as they determine it’s appropriate for your care. In many states, nurse practitioners and physician assistants may also. 

It’s important to discuss your condition with your healthcare provider before starting any medication. They will also want to monitor your progress and health while taking the drug. 

Off-Label Ozempic

The media touts Ozempic as a game-changer for treating obesity and related conditions. The pressure has led to a vast surge in its off-label use as a weight-loss aid. Public health experts worry about the long-term impact. 

Not only is Ozempic insurance coverage unpredictable and still leads to high out-of-pocket costs, but there are other concerns, like:

• Less reliance on healthy diets
• Decreased activity
• Side effects

If you’re not living with type 2 diabetes, Wegovy is the on-label path. 

Polycystic Ovarian Syndrome, also known as PCOS, is a health condition that contributes to obesity and insulin resistance in many women. A gynecologist can prescribe Ozempic for PCOS as an off-label treatment. It can help with weight loss and improve insulin levels. 

Ozempic vs. Wegovy – Indications, Age Limits, & Why It Matters

Indications

Ozempic and Wegovy are both GLP-1 medications that contain semaglutide. They have different FDA-approved semaglutide indications:

• Ozempic: Type 2 diabetes, chronic kidney disease, and cardiovascular outcomes benefits 
• Wegovy: Weight management for adults and teens 12 years or older

Why the Difference Matters

The safest option is taking a medication for its FDA-approved indication. The approval tells you several important things:

• It’s proven safe and effective. 
• The correct dose and timing
• Side effects and long-term effects studied
• Insurance will likely cover it

Age Limits of Ozempic vs. Wegovy

Age requirements differ between Ozempic vs. Wegovy. Clinicians can prescribe both medications for adolescents aged 12 and older with obesity. But Wegovy is specifically approved for this use. Studies show that semaglutide shows apparent short-term weight loss. But its safety and effectiveness in youth with obesity remains to be seen. 

Why It Matters

The FDA has only approved Wegovy for weight management in children and teens. Ozempic may not be the better choice. It’s essential to speak with your child’s pediatrician to discuss your options. 

The use of Ozempic and Wegovy may also be harmful to adolescents. It may trigger thoughts like:

• Thinking thinness equals worthiness
• Triggering an eating disorder
• Seeking shortcuts in other parts of life

There’s also a risk of stigmatizing their peers who cannot afford or access the therapy. Drugs aren’t the only solution to obesity. 

Clinical Eligibility – BMI, Comorbidities, & Labs

BMI Requirements

BMI stands for Body Mass Index. Your BMI is a health indicator because it measures your weight relative to your height. Clinicians classify a BMI into four main categories:

• Underweight
• Healthy Weight
• Overweight
• Obesity

The FDA’s weight-management guidelines use thresholds such as BMI, diagnoses, and comorbidities. Ozempic is for adults with type 2 diabetes. It also helps reduce the risk of major cardiovascular events in adults living with type 2 diabetes. Ozempic doesn’t specify a specific BMI requirement, as its goal is to treat diabetes. 

On the other hand, Wegovy has BMI requirements. Adults with a BMI greater than or equal to 30. It’s also approved for people with a BMI of 27 or higher who have at least one weight-related condition, such as hypertension or high cholesterol. Pediatric patients must have a BMI at or above the 95th percentile to qualify. 

Comorbidity Review

Beyond BMI, doctors look for weight-related conditions like:

• Type 2 diabetes
• High blood pressure
• PCOS
• High cholesterol
• Heart disease
• Sleep apnea
• Prediabetes

The conditions matter because they strengthen the case for treatment. Your health becomes a greater concern when your weight is causing harmful conditions. It’s also important since being overweight and living with a dangerous condition increases your risk for more serious harm.

Obesity is a chronic and harmful disease with an estimated 60 weight-related harmful comorbidities. An estimated 70% of American adults live with obesity today and may be at risk of more serious health conditions like stroke or heart attack. Medications like Ozempic and Wegovy help reduce these risks by supporting weight loss and improving health. 

Labs

Regularly monitoring your health while taking Ozempic vs. Wegovy allows your doctor to track your results and monitor side effects. They’re also a reliable indication of complications from the drugs. Healthcare professionals typically monitor:

• Blood glucose levels: Hemoglobin A1c and fasting glucose levels are key for establishing a baseline and monitoring the impact of drugs on diabetes management. 
• Urine and blood kidney testing: Creatinine and estimated glomerular filtration rate (eGFR) are key labs for detecting kidney injury associated with semaglutide. 
• Thyroid: Ozempic and Wegovy may increase the risk of thyroid cancer, so let your physician know if you have any concerns.  
• Cholesterol: As you lose weight, your doctor will also want to make sure your cholesterol levels are within a normal range.
• Liver: Wegovy is known to treat metabolic-associated steatohepatitis (MASH) in adults with liver disease, prompting the doctor to monitor its effectiveness through liver lab testing. 

Labs are there to ensure the GLP-1 therapy is safe. 

Who Can Prescribe Ozempic for Weight Loss (And When It’s Off-Label)?

Prescriber Types

In the U.S., GLP-1s require a prescription from a licensed physician. Nurse practitioners and physicians may also prescribe Ozempic and Wegovy. Virtual and telehealth clinicians may also prescribe the medications when they’re licensed in the patient’s state. But they must follow all state-specific laws and:

• Conduct a “good faith exam“
• Obtain informed consent
• Comply with the Health Insurance Portability and Accountability Act (HIPAA)

When seeking out Ozempic vs. Wegovy virtually, ensure the prescriber performs an appropriate health exam. You need a diagnosis to ensure you receive proper treatment. GLP-1 treatment isn’t for everyone. The provider should review your medical history, evaluate your current health, and look for any contraindications to keep you safe. 

Off-Label Rules

Remember: Ozempic isn’t FDA-approved for weight loss. That’s why many clinicians prefer Wegovy for weight management. Still, off-label prescribing of Ozempic for weight loss is legal when a licensed provider decides it’s appropriate for that patient. Each option, brand name or compound, comes with its own considerations. 

The FDA offers guidelines to help patients stay informed. Please consider the following:

• Compound drugs may be an option for those whose needs are not met by commercially available products.
• Patients need a prescription from their doctor, and you should use a licensed pharmacy.
• You can find resources to safely buy medications online by visiting the BeSafeRx website. 

Compounded medications are not FDA-approved, meaning they aren’t evaluated through the same federal review process as commercially manufactured drugs. Still, many patients use compounded options when prescribed by a licensed healthcare professional, especially when they need customized formulations.

Storage and handling are also essential to keep in mind: semaglutide products like Ozempic and Wegovy require refrigeration, and any temperature changes during shipping can affect how well the medication works.

Many reputable compound pharmacies follow the strict state and federal quality standards. Your prescription is also filled through a licensed pharmacy offering a safe alternative for people who need tailored dosing or access options. 

Wegovy is on the label as a treatment for obesity. Ozempic is not. That means that your insurance company will likely not cover it for strictly weight management.

Can a Gynecologist Prescribe Ozempic for PCOS?

Gynecologists and OB-GYNs are licensed physicians. They can prescribe medications, including Ozempic. Health experts find that semaglutide improves BMI and cholesterol in women living with PCOS. It’s because PCOS often involves insulin resistance, a known benefit of Ozempic therapy. 

Treatment decisions take into account factors such as reproductive plans. Ozempic indirectly boosts fertility since it helps lower the harmful effects of obesity and uncontrolled blood sugar that decrease fertility. They may also induce ovulation and regulate hormone levels. 

Health experts aren’t yet sure of Ozempic’s impact on pregnancy. Your doctor may suggest stopping the medication for a minimum of two weeks before trying to conceive. Coordinating care with an endocrinologist may also be ideal to ensure your treatment is proper for you. 

How Old Do You Have to Be to Take Ozempic for Weight Loss?

Today, the FDA approves Ozempic only for adults. It’s also only approved for type 2 diabetes. Wegovy is the only FDA-approved GLP-1 medication for weight loss in adults and adolescents 12 years of age and older. Health experts do not recommend Ozempic for children or teens, regardless of BMI.

The FDA has approved Wegovy for people 12 years of age and older who meet specific criteria. In adolescents, BMI must be at or above the 95th percentile. Your pediatrician uses an age and sex-specific growth chart to identify. But there’s more to consider.

Pediatricians also look for at least one weight-related comorbid condition. There’s the expectation that diet and lifestyle modification were tried and failed before turning to medication. Adolescents should try diet and exercise first to help manage their weight. They also need to continue these healthy habits while taking the drug. 

Step-by-Step: How Eligibility is Evaluated on a Telehealth Visit

Step 1: Medical Intake

Most telehealth visits begin with a questionnaire about your health history that should include:

• Review of current medications
• Diet
• Activity level
• Pregnancy status
• Allergies
• Symptoms
• Recent lab results

This step will allow them to identify any contraindications to Ozempic vs. Wegovy. 

Step 2: Virtual Exam & Vitals

Your telehealth clinician may ask you to provide a recent weight or to weigh on the same day. They may also ask about your recent vital signs and body measurements. If your labs are outdated, the practitioner may want more recent labs.

Step 3: Eligibility Review

The telehealth provider will determine whether Ozempic vs. Wegovy is appropriate. If you have type 2 diabetes or if you meet obesity criteria are both questions to consider. They’ll likely follow this path:

• Type 2 diabetes=Ozempic
• Obesity=Wegovy
• Other=Off-Label Ozempic

Keep in mind that your telehealth provider should not use off-label prescribing lightly. The safety and effectiveness of Ozempic vs. Wegovy are known only when used for an on-label indication. 

Step 4: Treatment Plan

Once eligibility is determined, the telehealth provider should outline a treatment plan you’re both comfortable with. The dosing should also follow a titration schedule to minimize side effects. Finally, the clinician has a planned follow-up visit to monitor your health and progress after starting therapy. 

Step 5: Prescription & Follow-Up

When the telehealth visit is complete, the provider sends your prescription to either a local or mail-order pharmacy. If using insurance, the pharmacy will file a claim with the provider for payment and request any applicable co-pays. The medication may require prior authorization before payment is released. Most clinicians schedule a follow-up in 4-8 weeks.

Risks, Contraindications, & Monitoring

Contraindications

As mentioned before, GLP-1 medications like Ozempic and Wegovy are not suitable for everyone. People with a personal or family history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2) are at an increased risk of thyroid tumors. It’s best to avoid using these medications to stay safe. 

Pancreatitis remains a potential risk. Studies link Ozempic and Wegovy to the condition, but the likelihood stays low. Research hasn’t confirmed a definite connection, yet if you already have risk factors for pancreatitis, you should avoid these medications.

Health experts don’t yet know the effects of GLP-1 medications on pregnancy or breastfeeding. That’s why clinicians recommend stopping Ozempic and Wegovy before you try to conceive or if you become pregnant. More long-term research is needed. 

Common Side Effects

Most people notice GI upset early in therapy. Common side effects of Ozempic include:

• Nausea
• Vomiting
• Diarrhea
• Belly pain
• Constipation

Wegovy has the same side effects, plus the following:

• Headache
• Fatigue
• Indigestion
• Dizziness
• Bloating
• Low blood sugar
• Gas
• Reflux

Eating small meals, staying hydrated, and starting at a low dose and gradually increasing it can help reduce your side effects. 

Monitoring Needs

Clinicians monitor your A1C during Ozempic therapy to monitor how it’s impacting your type 2 diabetes. A lower A1C tells them that the treatment is working to keep your blood sugar low. They typically will want to monitor your renal and thyroid function to ensure the therapy isn’t harming your kidneys and thyroid gland. 

Regular lab checks help ensure that the medications are working as they should and not harming your body. Frequent weight checks may also be part of the follow-up. If the medication isn’t helping you lose weight, it might not be the best choice. 

Insurance & Cost (Diabetes vs. Weight Loss Use)

Diabetes Coverage

Insurance will likely cover Ozempic when prescribed for on-label indications. A prior authorization request will request your doctor to send them evidence of:

• A type 2 diabetes diagnosis
• Previous treatments tried and failed
• Comorbidites 
• Recent A1C 

Weight-Loss-Only Coverage

Wegovy is different. Their on-label indication is for weight loss. So, your insurance provider may instead request your:

• BMI
• Previous treatments tried and failed
• Comorbidities

Medicare covers Wegovy for patients with obesity and related comorbidities. It doesn’t currently cover Ozempic. There’s news that this may change in the future. Commercial insurance coverage varies widely. Contact your plan to learn more. 

Frequently Asked Questions (FAQs)

Who qualifies for Ozempic?

Adults with type 2 diabetes qualify for Ozempic. Weight loss is not an approved indication. 

Who can prescribe Ozempic for weight loss?

Yes, OB-GYNS can prescribe Ozempic for PCOS off-label. They may consult an endocrinologist to provide input. 

Can my gynecologist prescribe Ozempic for PCOS?

Licensed prescribers can prescribe Ozempic for off-label use in weight loss. They must be an MD/DO/NP/PA and follow state laws and standards of care. 

What is the minimum age for semaglutide weight loss?

Regulators approve Wegovy for adults and for adolescents aged 12 and older who meet specific criteria for weight loss.

Is Ozempic safer than Wegovy?

Safety depends on different factors. Overall, they’re both generally safe when used as indicated. 

Get Started

If you’re ready to check your eligibility for Ozempic vs. Wegovy, let’s get started. One of our clinicians will help you decide whether a GLP-1 medication therapy program is best for you. We’re here to help!