BMI and GLP-1 Eligibility

How does my body mass index (BMI) determine eligibility for Semaglutide or Tirzepatide?
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Body mass index (BMI) is a number calculated from a person's weight and height. It is used to classify weight status and is a key factor in deciding if certain weight loss medications, like semaglutide and tirzepatide, are appropriate.
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​Eligibility Criteria Based on BMI
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- Semaglutide and tirzepatide are FDA-approved for weight management in adults who meet one of the following BMI criteria:
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- BMI of 30 or higher: This is considered the threshold for obesity. Adults with a BMI of 30 kg/m² or greater are eligible for these medications, even if they do not have other health problems related to weight.[1][2][3][4][5][6][7][8]
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- BMI of 27 or higher with at least one weight-related health condition: Adults with a BMI between 27 and 29.9 kg/m² (classified as overweight) may be eligible if they also have at least one weight-related comorbidity. Common qualifying conditions include high blood pressure (hypertension), high cholesterol (dyslipidemia), type 2 diabetes, obstructive sleep apnea, or cardiovascular disease.[1][2][3][4][5][6][7][8]
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​Why is BMI Used?
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BMI is a simple and widely used measure to estimate body fat and assess health risks related to weight. Clinical trials and guidelines use BMI to identify people who are most likely to benefit from weight loss medications and to ensure safe and effective use.[1][2][3][4][5][6][7][8]
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​Other Important Considerations
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- Lifestyle Changes: These medications are meant to be used along with healthy eating and increased physical activity. They are not a substitute for lifestyle changes.[1][6][4]
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- Comorbidities: If a person has a BMI of 27 or higher and a weight-related health problem, this increases the potential benefit of medication and is part of the eligibility criteria.[1][2][3][4][5][6][7][8]
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- Age: Semaglutide is approved for adults and youth aged 12 and older, while tirzepatide is approved for adults aged 18 and older.[1]
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- Contraindications: These medications are not suitable for everyone. People with a personal or family history of certain rare cancers (like medullary thyroid carcinoma) or specific genetic syndromes (like multiple endocrine neoplasia type 2) should not use them.[2]
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​Summary Table
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​How to Calculate BMI
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BMI is calculated as:
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BMI = weight (kg) ÷ [height (m)]²
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For example, a person who weighs 90 kg and is 1.7 meters tall has a BMI of 31.1.
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​Key Takeaways
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- A BMI of 30 or higher, or a BMI of 27 or higher with a weight-related health problem, is required for eligibility for semaglutide or tirzepatide for weight management.
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- These medications should be used together with healthy lifestyle changes.
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- Always discuss with a healthcare provider to determine if these medications are appropriate, considering individual health history and goals.
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