Endocrinologists prescribe weight loss injections for adults with a body mass index above 30, or above 27 when there is a weight-related condition such as type 2 diabetes, high blood pressure or high cholesterol. Meeting the threshold does not by itself mean the medication will be prescribed. Your endocrinologist will also review your medical history, your blood tests and your body composition analysis, and will check whether any condition means the medication is not appropriate for you.
- The standard thresholds are a BMI above 30, or above 27 with a weight-related condition such as type 2 diabetes, hypertension or high cholesterol.
- The FDA prescribing information for Wegovy and for Zepbound, the weight management version of tirzepatide, describes the same two criteria for adults.
- Ozempic is licensed for type 2 diabetes, and the weight management indication for semaglutide belongs to Wegovy, which contains the same active ingredient.
- BMI does not separate body fat from muscle, so two patients at the same BMI can have very different body composition and different treatment needs.
- Some patients should not take a GLP-1 injection, including women who are pregnant or breastfeeding and people with a personal or family history of medullary thyroid cancer.
- Eligibility is assessed by an endocrinologist at a consultation that includes a physical examination, a review of blood tests and body composition analysis.
- A smaller weight loss goal does not automatically mean medication is needed, and for many patients the focus is a personalised nutrition and activity plan with regular follow-up.
Eligibility for weight loss medication depends on your BMI, on any weight-related health conditions and on a medical assessment by your endocrinologist.
What BMI do you need for a weight loss injection?
Our endocrinologists prescribe weight loss medication for patients with a body mass index above 30, or above 27 where there is a weight-related condition such as type 2 diabetes, hypertension or high cholesterol. The National Institute of Diabetes and Digestive and Kidney Diseases describes the same two criteria for prescription weight management medicines in adults: a BMI of 30 or above, or a BMI of 27 or above with at least one weight-related health problem. The UAE National Health Survey 2017 to 2018, published by the Ministry of Health and Prevention, found that 27.8% of adults aged 18 to 69 had a BMI of 30 or above.
The FDA prescribing information for Wegovy and the FDA prescribing information for Zepbound, the weight management version of tirzepatide, both describe clinical trials in adults meeting those criteria. Wegovy is also approved for adolescents aged 12 years and older, unlike Mounjaro and Foundayo, which are approved for adults only. Our endocrinologists never prescribe weight loss medication on request, and never for cosmetic weight loss in a person with a healthy weight.
Which conditions lower the threshold?
A weight-related condition can bring the threshold down from a BMI above 30 to a BMI above 27. Which conditions qualify depends on the medication’s approved indication and on your endocrinologist’s assessment. Examples include:
- Type 2 diabetes or prediabetes
- Insulin resistance
- High blood pressure
- High cholesterol or raised triglycerides
- Obstructive sleep apnoea
- Fatty liver disease
- Polycystic ovary syndrome (PCOS)
The list is not exhaustive, and the condition has to be documented. Your endocrinologist will review blood tests from the last three months before prescribing, and those results are what confirm conditions such as prediabetes, insulin resistance and raised cholesterol. If your results are out of date, the clinic can arrange the required tests.
What does BMI not tell you?
BMI is calculated from height and weight alone. It is a useful screening tool and it is the measure the prescribing information uses. It does not distinguish between body fat and muscle, and it does not say where body fat is stored.
Fat against muscle
Two patients can have the same BMI with very different body composition. A patient who trains with weights can sit above a BMI of 27 with a healthy body fat percentage, while a patient with a normal BMI can carry a high proportion of body fat and little muscle. At Endocare, body composition analysis is included free of charge at every consultation. Body composition analysis estimates body fat, muscle mass and body water. Repeated measurements help your endocrinologist understand how your body is changing beyond the number on the scale. Our article on the difference between fat loss and weight loss explains why the distinction changes the plan.
Where the fat sits
Fat stored around the abdominal organs, known as visceral fat, is more closely associated with insulin resistance, type 2 diabetes and cardiovascular disease than fat stored under the skin. Waist circumference is a simple measure of it, and a body composition analysis can estimate visceral fat and provide a visceral fat rating that can be tracked over time. For many patients in the UAE, lower ethnicity-specific waist or BMI thresholds may therefore be more appropriate, which is one reason the assessment looks beyond a single number.
Who should not take a weight loss injection?
The prescribing information for each medication lists the people who should not use it, and your endocrinologist checks this at the consultation before prescribing anything. The FDA prescribing information for Wegovy and for Zepbound states that a GLP-1 injection should not be used by:
- Anyone with a personal or family history of medullary thyroid carcinoma
- Anyone with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Anyone who has had a serious allergic reaction to the medication or its ingredients
The medication is also not used during pregnancy because it may harm an unborn baby, and it is not recommended while breastfeeding. A history of pancreatitis, severe gastrointestinal disease, or certain other medications taken at the same time are among the points your endocrinologist will assess before prescribing. Patients should not decide by themselves to start a GLP-1 medication. A doctor’s review is critical to ensure the treatment is safe and appropriate for the individual.
How does Endocare assess eligibility?
Your first appointment is a full medical assessment, not simply a prescription visit. Your endocrinologist will take a full medical history, review your blood tests and examine you before discussing treatment options. The assessment covers whether a weight loss injection, an oral GLP-1 such as the Wegovy pill or Foundayo, or a plan without medication is the right option for you. Our page on what a consultation involves sets out each step.
Where possible, your first appointment takes place in person at Endocare’s Dubai clinic, as the physical examination and body composition analysis cannot be completed remotely. Monthly follow-up appointments can be held in person at the clinic or online. If your endocrinologist prescribes a weight loss injection, the options include Wegovy, Mounjaro and, where type 2 diabetes or prediabetes is present, Ozempic, with the choice made from your assessment.
A smaller weight loss goal does not automatically mean medication is needed. Your endocrinologist will assess whether medication is appropriate based on your individual health and weight profile. For many patients with a smaller weight loss goal, the focus is on a personalised nutrition and activity plan with regular follow-up, led by Endocare’s lifestyle coaches.
Frequently asked questions
What BMI do I need for Ozempic or Mounjaro?
A BMI above 30, or above 27 with a weight-related condition, for a weight management prescription. Ozempic itself is licensed for type 2 diabetes, and our article on whether you can get Ozempic for weight loss in the UAE if you are not diabetic explains how that affects prescribing. Endocrinologists prescribe Mounjaro for weight management on the same two criteria.
Can I get a weight loss injection at BMI 25?
Generally, no. A BMI of 25 sits below both thresholds, so a weight loss injection would not normally be prescribed. Your endocrinologist can still assess your body composition and your metabolic health, and for many patients at this BMI the focus is a personalised nutrition and activity plan with regular follow-up.
Which conditions count as a weight-related condition?
The weight-related conditions that qualify depend on the medication’s approved indication and on your endocrinologist’s assessment. Examples include type 2 diabetes, prediabetes, high blood pressure and high cholesterol. Obstructive sleep apnoea, fatty liver disease and polycystic ovary syndrome may also be relevant. The condition has to be documented, which is why up-to-date blood tests are part of the assessment.
What if my BMI is high but I am muscular?
Body composition analysis helps answer this. It estimates body fat percentage and skeletal muscle mass, so a high BMI that reflects muscle rather than body fat can be seen at the first consultation. Your endocrinologist will base the decision on that analysis and on your metabolic health, as well as on BMI.
Can I get a weight loss injection if my BMI is normal but I carry weight around my middle?
Not on BMI alone, and weight around the abdomen is a reason to be assessed. Measuring waist circumference or body composition can be useful when there are signs of increased metabolic risk, such as a raised waist measurement or abnormal glucose or lipid results. Your endocrinologist will assess whether any treatment is appropriate from the whole picture.
Who should not take a weight loss injection?
Women who are pregnant or breastfeeding, and anyone with a personal or family history of medullary thyroid carcinoma or with Multiple Endocrine Neoplasia syndrome type 2. Your endocrinologist will also assess a previous serious allergic reaction to the medication, a history of pancreatitis and certain other conditions before prescribing. A doctor’s review is critical to ensure the treatment is safe and appropriate for the individual.
If you want to know whether a weight loss injection is appropriate for you, the first step is a consultation. Your endocrinologist will review your medical history, your blood tests and your body composition analysis, and will tell you which treatment, if any, fits your health and your goal.
You can book a consultation with an endocrinologist at our clinics in Dubai and Abu Dhabi.
