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BMI first. Then your health history.
Tirzepatide BMI requirements: do you qualify?
Medically reviewed by the NexLife clinical team, led by Adam Kennah, MD · Updated
The BMI requirement for tirzepatide (Zepbound) is 30 or more, or 27 or more with a weight-related condition, per its FDA approval on November 8, 2023. For compounded tirzepatide, no FDA label sets the line: a licensed provider reviews your BMI and health history and decides.
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- FDA line: BMI 30, or 27 with a weight-related condition
- Medicare’s Bridge: BMI 35, or 27 or 30 with listed conditions
- Some insurers: a BMI of 40
$139/mo on a 12-month plan, all-inclusive, same price at every dose
Or $169/mo month to month
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Compounded tirzepatide isn’t FDA-approved, and no FDA label sets who it’s for. A licensed provider prescribes it only when it offers a significant difference for you.
Key takeaways
- The FDA line: Zepbound is approved for adults with a BMI of 30 or more, or 27 or more with a weight-related condition. The FDA named high blood pressure, type 2 diabetes and high cholesterol.
- Wegovy and Foundayo work the same way: obesity, or overweight with a weight-related condition. The Wegovy shot is also approved for teens 12 and older with obesity.
- Insurers often ask for more. Some plans require a BMI of 40. Medicare’s
GLP-1 Bridge asks for 35, or 27 to 34.9 with specific conditions. - After you lose weight: Zepbound is approved to keep weight off long term, and Medicare’s Bridge judges your BMI when you start. A private plan’s renewal may look at your BMI today.
- At NexLife, a licensed provider reviews your BMI and health history and decides. Compounded tirzepatide is $139 a month on the 12-month plan or $169 month to month, at every dose.
Check your BMI
What’s your BMI, and where does it land?
Enter your height and weight to see your BMI next to the lines that matter: 27 and 30 for Zepbound’s FDA approval, 35 for Medicare’s
Enter your height and weight to see your BMI.
BMI = weight (lb) ÷ height (in)² × 703. A licensed provider looks at your whole health history, not BMI alone.
Weight at each BMI line, by height
| Height | BMI 27 | BMI 30 | BMI 35 | BMI 40 |
|---|---|---|---|---|
| 4 ft 10 in | 129 lb | 144 lb | 167 lb | 191 lb |
| 5 ft 0 in | 138 lb | 154 lb | 179 lb | 205 lb |
| 5 ft 2 in | 148 lb | 164 lb | 191 lb | 219 lb |
| 5 ft 4 in | 157 lb | 175 lb | 204 lb | 233 lb |
| 5 ft 6 in | 167 lb | 186 lb | 217 lb | 248 lb |
| 5 ft 8 in | 178 lb | 197 lb | 230 lb | 263 lb |
| 5 ft 10 in | 188 lb | 209 lb | 244 lb | 279 lb |
| 6 ft 0 in | 199 lb | 221 lb | 258 lb | 295 lb |
| 6 ft 2 in | 210 lb | 234 lb | 273 lb | 312 lb |
| 6 ft 4 in | 222 lb | 246 lb | 288 lb | 329 lb |
Swipe the table sideways to see every column.
The weight, in pounds, at which an adult of each height reaches each BMI, rounded to the nearest pound. BMI = weight (lb) ÷ height (in)² × 703, the CDC’s formula. BMI is a screening measure: it doesn’t measure body fat directly.
The FDA line
What BMI does the FDA set for Zepbound?
A BMI of 30 or more, or 27 or more with at least one weight-related condition. That’s how the FDA described Zepbound’s approval on November 8, 2023, and the line its trials used. So with a BMI of 27 to 29.9, you need a weight-related condition to be inside it. Under 27, you’re outside the range it was approved for.
“Zepbound (tirzepatide) injection for chronic weight management in adults with obesity (body mass index of 30 kilograms per square meter (kg/m²) or greater) or overweight (body mass index of 27 kg/m² or greater) with at least one weight-related condition (such as high blood pressure, type 2 diabetes or high cholesterol)”
Today’s Zepbound label, revised in August 2026, words it as “adults with obesity or adults with overweight in the presence of at least one weight-related comorbid condition.” Its trials put numbers on both: a BMI of 30 or more, or 27 to under 30 with a weight-related condition. Those conditions included high blood pressure, high cholesterol, sleep apnea and heart disease. Zepbound is also approved to treat moderate to severe obstructive sleep apnea in adults with obesity.
How do Wegovy and Foundayo compare?
They draw the same kind of line. Wegovy is approved for adults with obesity, or overweight with a weight-related condition, and the shot also for ages 12 and up with obesity. Foundayo, a daily pill approved April 1, 2026, covers adults with obesity, or overweight with a weight-related problem. Compounded tirzepatide has no FDA approval or label.
| Medicine | Approved for weight loss in | Also approved for |
|---|---|---|
| Zepboundtirzepatide, weekly shot | Adults with obesity (BMI 30 or more), or overweight (BMI 27 or more) with a weight-related condition | Moderate to severe obstructive sleep apnea in adults with obesity |
| Wegovysemaglutide, weekly shot or daily pill | Adults with obesity, or overweight with a weight-related condition; the shot also for ages 12 and up with obesity | Lowering the risk of heart attack, stroke and heart-related death in adults with heart disease and obesity or overweight; the shot also treats MASH, a liver disease |
| Foundayoorforglipron, daily pill | Adults with obesity, or overweight with a weight-related medical problem | Approved April 1, 2026 |
| Compounded tirzepatidenot FDA-approved | No FDA approval or label. A licensed provider decides, case by case | Compounded versions weren’t tested in Zepbound’s trials |
Swipe the table sideways to see every column.
From the FDA’s Zepbound approval (November 8, 2023) and the Zepbound and Wegovy prescribing information, read October 21, 2026; Foundayo from Lilly’s approval announcement. The adult trials behind Zepbound and Wegovy enrolled people with a BMI of 30 or more, or 27 to 29.9 with a weight-related condition.
What about Mounjaro? It’s tirzepatide too, approved to help lower blood sugar in type 2 diabetes. Its label has no BMI line, and it isn’t approved for weight loss.
Conditions
Which weight-related conditions count with a BMI of 27?
When it approved Zepbound on November 8, 2023, the FDA named high blood pressure, type 2 diabetes and high cholesterol as examples. Zepbound’s trials also counted obstructive sleep apnea and heart disease. It isn’t a closed list, so your provider decides what counts in your case.
High blood pressure
Hypertension, treated or not. One of the conditions the FDA named.
High cholesterol
Or other blood-fat problems (dyslipidemia). Also named by the FDA.
Type 2 diabetes
Named by the FDA. One of Zepbound’s trials enrolled adults with type 2 diabetes and a BMI of 27 or more.
Obstructive sleep apnea
Counted in Zepbound’s trials. With obesity, it’s also its own approved use.
Heart disease
Cardiovascular disease, counted in Zepbound’s trials.
Insurers and Medicare
Why do insurers and Medicare ask for more?
Because they pay, they set their own bar above the label. Medicare’s
Medicare’s GLP-1 Bridge
| If your BMI is | You also need one of these |
|---|---|
| 35 or more | Nothing more: BMI alone qualifies |
| 30 or more | Heart failure with preserved ejection fraction, uncontrolled high blood pressure or chronic kidney disease stage 3a or higher (or a condition in the next row) |
| 27 or more | Prediabetes, a past heart attack or stroke, or peripheral artery disease with symptoms |
Swipe the table sideways to see every column.
Medicare
The Bridge covers Wegovy, Foundayo and the Zepbound KwikPen for a $50 copay, with prior authorization. Who isn’t eligible: people who already get a
Private insurance
Plans set their own rules on top of the label. GoodRx found that 88% of people who still have coverage face a limit, typically prior authorization or a BMI of 40. That’s well above the BMI of 30 that defines obesity. A renewal may also look at your BMI today, not when you started. If your plan dropped coverage or denied a renewal, here’s what to do when insurance stops covering it.
Online programs
How do online programs decide?
A licensed provider reviews your whole health history, not just your BMI. Expect questions on five things: your height and weight, your conditions, your medicines, anything that rules treatment out, and recent lab results. Zepbound’s label sets no lab test everyone needs first. Have a recent weight and any lab results ready.
Your height and weight
That gives your BMI. Have a recent weight ready.
Your conditions
Blood pressure, cholesterol, blood sugar, sleep apnea and heart health.
Your medicines
Especially insulin or a sulfonylurea: with tirzepatide, they raise the risk of low blood sugar.
Health history that rules it out
Such as a personal or family history of medullary thyroid cancer. More on that below.
Recent lab results
Some providers order lab work; others ask for recent results if you have them.
What if your BMI is under 27?
Below 27, you’re outside the range Zepbound was approved and studied for, and insurers and Medicare won’t cover it for weight loss. A BMI of 25 to 26.9 still counts as overweight, so talk with your own doctor about what fits.
Be wary of any seller that skips the health review or promises there’s no BMI requirement. A real tirzepatide prescription starts with a licensed provider’s review.
Safety
What can rule you out?
A few things. Zepbound’s label (revised August 2026) rules tirzepatide out with a personal or family history of medullary thyroid carcinoma or MEN 2, or a serious allergy to it. In pregnancy, it says to stop. It isn’t recommended with severe gastroparesis. Your provider goes through each one with you.
The label says no
- A personal or family history of medullary thyroid carcinoma (MTC), or multiple endocrine neoplasia syndrome type 2 (MEN 2)
- A serious allergic reaction to tirzepatide or to anything else in the product
- Pregnancy: the label says weight loss offers no benefit, and to stop when a pregnancy is recognized
- Severe gastroparesis: the label doesn’t recommend Zepbound
- Another
GLP-1 medicine or tirzepatide product at the same time: not recommended
It needs extra care
- A past bout of pancreatitis: Zepbound wasn’t studied in people who’ve had it
- Diabetes: blood sugar is checked before and during treatment, and insulin or a sulfonylurea may need a lower dose
- Diabetic eye disease (retinopathy): it’s watched for changes
- Under 18: Zepbound’s safety and effectiveness haven’t been established
For the full list, see tirzepatide side effects and the safety information below.
At NexLife
How does NexLife decide if you qualify?
A licensed provider reviews your health history and decides; there’s no automatic yes. No FDA label sets a BMI line for compounded tirzepatide, so your BMI is weighed with your conditions, medicines and history. It’s prescribed only when it offers a significant difference for you.
You start with a 3-minute online health assessment: your height, weight, conditions, medicines and history. A licensed provider reviews it and prescribes compounded tirzepatide only if it’s right for you, and only when it offers a significant difference for you. If you’re not prescribed, you aren’t charged for medication.
If you are, it’s $139 a month on the 12-month plan, or $169 month to month, at every dose. Care, a nutrition plan, a 1:1 coaching call and free expedited shipping are included.
Not sure you qualify? Call or text
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Qualifying for tirzepatide: your questions
What BMI do you need for tirzepatide?
Zepbound’s FDA approval covers adults with a BMI of 30 or more, or 27 or more with at least one weight-related condition. Examples include high blood pressure, type 2 diabetes and high cholesterol. For compounded tirzepatide, a licensed provider decides after reviewing your BMI and health history.
Can I get tirzepatide with a BMI of 25?
Not within Zepbound’s FDA approval: a BMI of 25 to 26.9 is below the line it was approved and studied for. Insurers and Medicare won’t cover it for weight loss. Any prescription would be a licensed provider’s call after a full health review, so be wary of sellers that skip one.
What conditions count with a BMI of 27?
When it approved Zepbound, the FDA named high blood pressure, type 2 diabetes and high cholesterol. Its trials also counted obstructive sleep apnea and heart disease. Your provider decides what counts in your case.
Does my BMI still count after I lose weight?
Zepbound is approved to help keep weight off long term, not only to lose it, and Medicare’s
What BMI do you need for the Medicare GLP-1 Bridge?
A BMI of 35 or more qualifies on its own. A BMI of 30 or more qualifies with heart failure with preserved ejection fraction, uncontrolled high blood pressure or chronic kidney disease stage 3a or higher. A BMI of 27 or more qualifies with prediabetes, a past heart attack or stroke, or peripheral artery disease with symptoms. You also need Part D and prior authorization.
Do I need lab work to qualify?
Zepbound’s label doesn’t set a lab test everyone needs before starting. If you have diabetes, it says to check your blood sugar before and during treatment. Some providers order other labs based on your history, so have any recent results ready.
How do I calculate my BMI?
Divide your weight in pounds by your height in inches squared, then multiply by 703. At 5 feet 6 inches, a BMI of 27 starts at about 167 pounds and a BMI of 30 at about 186 pounds.
Is there an age limit for tirzepatide?
Zepbound is for adults: its safety and effectiveness haven’t been established in children. Its label reports no overall differences in safety or effectiveness between people 65 and older and younger adults.
How does NexLife decide if I qualify?
A licensed provider reviews your answers to a 3-minute online health assessment: your height and weight, conditions, medicines and history. They prescribe compounded tirzepatide only if it’s right for you, and if you’re not prescribed, you aren’t charged for medication.
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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Who checked this page
Leads the NexLife clinical team, which medically reviewed this page on October 26, 2026.
FDA labels, Medicare’s rules and the CDC formula checked October 21, 2026.
- How we checked. The BMI lines come from the FDA’s Zepbound approval announcement and the current Zepbound and Wegovy prescribing information, read October 21, 2026. Medicare’s rules come from Medicare.gov, read October 21, 2026. Insurance limits come from GoodRx’s analysis as NPR reported it (April 22, 2026). The BMI formula and categories are the CDC’s; the weights in the table are calculated from that formula.
- 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.
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Think you qualify? Start with a 3-minute assessment.
A licensed provider reviews your BMI and health history and decides if compounded tirzepatide is right for you. It’s $139 a month on the 12-month plan, or $169 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.
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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
- FDA: FDA approves new medication for chronic weight management (Zepbound). November 8, 2023; read October 21, 2026.
- Zepbound (tirzepatide) prescribing information, Eli Lilly, revised August 2026. Read October 21, 2026.
- Wegovy (semaglutide) prescribing information, Novo Nordisk, revised June 2026. Read October 21, 2026.
- Eli Lilly: FDA approves Lilly’s Foundayo (orforglipron), news release (April 1, 2026).
- Medicare.gov: Weight loss drugs (the Medicare
GLP-1 Bridge). Read October 21, 2026. - NPR: Restrictions on obesity drug coverage force patients to pivot (April 22, 2026).
- CDC: Adult BMI categories. Read October 21, 2026.
- CDC: BMI frequently asked questions (the formula). Read October 21, 2026.
- NexLife: compounded tirzepatide plans.