How to find a GLP-1 provider, and what to ask them

Semaglutide and tirzepatide are prescription medicines, so the first step is a prescriber. There is no single right kind. People get excellent care from a family doctor and poor care from a specialist, and the reverse. What separates a good fit is less the title on the door than how the prescriber handles the first three months: the baseline labs, the dose steps, and what happens when side effects arrive.

The main options

About ABOM certification. To sit the ABOM exam, a physician needs an active, unrestricted licence in the US or Canada, a completed residency, active certification from a member board, and either 60 credits of obesity-related continuing education or a recognised obesity medicine fellowship. It is a signal of focused training. It is not the only route to good care.

About telehealth. A telehealth visit is a medical visit like any other. The clinician needs to be licensed in the state where you are when the visit happens, and the prescription goes to a pharmacy that fills it. Worth confirming up front: whether labs are ordered and where you get them drawn, whether follow-up is by video or message, how quickly messages are answered, and whether the product is a branded pen or a compounded vial.

Questions worth asking

These are not tests to catch anyone out. They are the questions whose answers shape the next year.

1. Which labs do you want before I start, and when do we repeat them? The GLP-1 blood work page covers what is usually ordered and why.
2. What is the titration plan? How long at each step, what happens if a step is rough, and what decides the maintenance dose. The labelled schedules are on the titration and tirzepatide titration pages.
3. How often will we check in, and who do I contact between visits? Side effects cluster in the first weeks of each step. A same-week route to someone matters more than the length of the first appointment.
4. Is this the FDA-approved product or a compounded preparation? If compounded, which pharmacy prepares it, and what is on the label. FDA's current position on compounded GLP-1s is set out on the FDA and compounded GLP-1 page, and the compounded entry explains the terms.
5. What will it cost, and through which route? Insurance, a manufacturer self-pay programme, or cash at a pharmacy. The costs page has current figures.
6. What is the plan for muscle? Protein and resistance training targets, and whether body composition will be measured. See preventing muscle loss.
7. What happens long term? Whether the plan is to stay on a maintenance dose, taper, or stop, and what the trials say about each.

Insurance and prior authorisation

Coverage depends on the plan, the drug and, increasingly, the indication. A prior authorisation is a request from the prescriber to the insurer showing that you meet the plan's criteria. Plans commonly ask for BMI, weight-related conditions and the diagnosis code, and some ask for evidence of earlier attempts or require re-authorisation after a set period. A denial can be appealed, and the prescriber's office usually files it.

The indication can decide it. Medicare Part D has excluded drugs used for weight loss since the programme began in 2006. But in March 2024 the FDA approved Wegovy to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and obesity or overweight, and CMS said a drug approved for such a use can be covered under Part D for that use. In December 2024 the FDA approved Zepbound for moderate to severe obstructive sleep apnoea in adults with obesity, and CMS applied the same rule. Plans may still require prior authorisation. The sleep apnoea and SELECT pages cover the trials behind those approvals.

Self-pay

Both manufacturers sell direct to patients. Eli Lilly's LillyDirect offers Zepbound, and Novo Nordisk's NovoCare Pharmacy offers Wegovy, at self-pay prices that do not require insurance but do require a prescription. Prices have changed several times since 2024, so the costs page keeps the current numbers rather than this one.

Comparing options fairly

A lower monthly price can mean a different product, fewer visits or no labs. A higher one can include a dietitian and body composition scans. Neither is automatically better. Write down, for each option, the product, the follow-up, the labs, the total monthly cost and who answers the phone when you are sick at week two. The comparison is usually obvious once it is on one page. For how the medicines themselves compare, see Ozempic vs Wegovy vs Mounjaro vs Zepbound.

Whoever prescribes, a log of each dose, step, side effect and weigh-in makes every follow-up shorter. Peptide AI keeps that log free, and Premium adds bloodwork on the same timeline. The free GLP-1 tracker page explains what is included.