If you’ve tried diets, gym memberships and meal plans and the scale still won’t budge, you may be wondering whether medical weight loss is an option for you. The most common question we hear at TrueBalance is simple: “Do I qualify?”
The short answer is that it depends mainly on your BMI and your overall health. Below we explain the numbers, the health factors providers look at, and what happens at a first visit, so you know what to expect before you book.
Quick answer
Most prescription weight-loss programs look at two things. First, your body mass index (BMI). Second, whether you have weight-related health conditions. Medications are generally recommended for a BMI of 30 or higher, or a BMI of 27 or more along with conditions made worse by excess weight, such as high blood pressure, abnormal cholesterol or type 2 diabetes. A provider confirms your eligibility after reviewing your full health history.
What is BMI, and how do you calculate it?
BMI is a number that compares your weight to your height. It gives providers a quick starting point for judging health risks linked to weight.
Formula (pounds and inches): weight in pounds ÷ (height in inches × height in inches) × 703
Example: someone who is 5’6″ (66 inches) and weighs 190 lb has a BMI of about 30.7.
| BMI | Category |
| Under 18.5 | Underweight |
| 18.5 to 24.9 | Healthy weight |
| 25 to 29.9 | Overweight |
| 30 to 34.9 | Obesity, Class 1 |
| 35 to 39.9 | Obesity, Class 2 |
| 40 and above | Obesity, Class 3 |
You can also ask us to calculate it for you at your visit.
The BMI thresholds for medical weight loss
BMI of 30 or higher
If your BMI is 30 or above, you may qualify for medical weight loss even without other health conditions, provided a provider confirms it’s safe for you.
BMI of 27 or higher with a weight-related condition
If your BMI is between 27 and 29.9, you may still qualify if you have at least one condition that’s linked to or worsened by excess weight. For example, someone who is 5’4″ and weighs 165 lb has a BMI of about 28.3. With high blood pressure, that person could be a candidate.
BMI under 27
Prescription weight-loss medications are generally not recommended for people in this range. If this is you, a provider can still help with nutrition, activity and other wellness options.
These cutoffs are guidelines, not guarantees. Your provider decides what’s appropriate for you.
Health factors that can help you qualify
Weight-related conditions that providers commonly look at include:
- High blood pressure (hypertension)
- Type 2 diabetes or prediabetes
- High cholesterol or triglycerides (dyslipidemia)
- Sleep apnea
- Fatty liver disease
- Joint pain related to excess weight
- Polycystic ovary syndrome (PCOS)
- Heart disease risk factors
If you have one or more of these, mention them at your consultation, because they can change both your eligibility and your treatment plan.
Other things providers consider
BMI is only one piece of the picture. Your provider will also look at:
- Your weight-loss history. Providers usually want to know whether you’ve tried diet and exercise, and what happened.
- Your medical history. Some past conditions can make certain medications unsuitable, so your provider reviews these carefully.
- Your current medications. Some prescriptions can interact with weight-loss treatments or affect your weight.
- Your hormones and metabolism. Thyroid, blood sugar and other lab results can explain why weight has been hard to lose. If hormones are part of the picture, our bioidentical hormone replacement therapy team can help.
- Your goals and lifestyle. Your schedule, eating habits and support system shape which plan works best.
Who may not be a good candidate?
Medical weight loss isn’t right for everyone. Your provider may recommend a different approach if you:
- Are pregnant, planning to become pregnant, or breastfeeding
- Have certain personal or family histories that make specific medications unsafe
- Have a history of pancreatitis or certain other conditions
- Have an active eating disorder
- Are under 18 (this program is for adults)
This list isn’t complete. That’s why a proper medical review comes first, and why you should never start weight-loss medication without one.
The limits of BMI
BMI is useful, but it isn’t perfect. It doesn’t measure body fat directly, and it can’t tell muscle from fat. A muscular person may have a high BMI without excess body fat, while someone with a normal BMI may carry more fat than is healthy. That’s why your provider looks at your whole health picture rather than one number.
What to expect at your consultation
At TrueBalance, your first visit is about understanding you, not just your weight. You can expect:
- A conversation about your history, including past weight-loss attempts, health conditions and goals
- A review of your current medications and supplements
- Measurements, such as height, weight, BMI and blood pressure
- Lab work if needed to check things like blood sugar, cholesterol and thyroid levels
- A personalized plan that may include medication, nutrition guidance, activity goals and follow-up visits
Which treatments might be an option?
If you qualify, your provider will discuss which approach fits you best. Options may include:
- GLP-1 weight loss treatment
- Combination of GLP-1 and GIP treatment
- Phentermine
- Qsymia
- Daily oral weight-loss medications
Every option has benefits and risks, and your provider will help you choose. It also helps to think ahead about the long term, so read our guide on what happens when you stop a GLP-1.
For more on how weight-loss medications are used and who they’re meant for, the National Institute of Diabetes and Digestive and Kidney Diseases has a helpful overview: Prescription Medications to Treat Overweight & Obesity (NIDDK).
Frequently asked questions
What BMI do I need to qualify for medical weight loss?
Generally a BMI of 30 or higher, or 27 or higher with a weight-related health condition. Your provider makes the final decision after reviewing your health history.
Can I qualify if my BMI is under 27?
Prescription weight-loss medication is generally not recommended in that range. A provider can still discuss other ways to support your health and goals.
Do I need to have tried dieting first?
Providers usually ask about your past efforts, and medication is meant to be used alongside healthy eating and activity, not instead of them. If you’ve tried without lasting results, tell us about it.
Do I need blood work before starting?
Often yes. Labs help your provider check for conditions that affect your weight and make sure treatment is safe for you.
Is medical weight loss covered by insurance?
Coverage varies by plan and by treatment. If cost is a concern, ask us about our payment plans.
How long does it take to find out if I qualify?
In most cases you’ll know at your consultation, once your provider has reviewed your history and measurements.
The bottom line
If your BMI is 30 or higher, or 27 or higher with a weight-related condition, you may be a candidate for medical weight loss. But numbers are only the starting point. A provider needs to look at your health history, your medications and your goals to decide what’s safe and effective for you.
Find out if you qualify
Not sure where you stand? TrueBalance Weight and Hormone Clinic team can review your health history, check your BMI and build a plan around you. Learn more about our medical weight loss program in Orlando, FL, or book your consultation today.
This article is for educational purposes only and isn’t medical advice. Talk with a qualified healthcare provider before starting, changing or stopping any medication. See our medical disclaimer.