Semaglutide Eligibility: Who Can and Can't Use This Weight Loss and Diabetes Drug

When you hear semaglutide, a GLP-1 receptor agonist used to treat type 2 diabetes and aid in weight loss. Also known as Ozempic for diabetes and Wegovy for weight loss, it’s one of the most talked-about medications in India right now. But not everyone can take it—and not everyone should. If you’re considering semaglutide, you need to know who it’s designed for, who it could harm, and what doctors check before prescribing it.

The biggest factor in semaglutide eligibility, the medical criteria determining if a patient can safely use this drug is your health history. People with a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia Syndrome Type 2 are banned from using it. That’s not a gray area—it’s a hard stop. If you’ve had pancreatitis, severe gastrointestinal issues, or uncontrolled type 1 diabetes, your doctor will likely say no. Even if you’re overweight, if you don’t have type 2 diabetes and your BMI is below 30, you may not qualify for Wegovy under most insurance plans in India. And yes, insurance companies like Express Scripts now require proof of failed diet attempts, documented BMI, and sometimes even mental health screenings before approving coverage.

It’s not just about weight or blood sugar. Your kidneys and liver matter too. Semaglutide is processed through both organs, so if you have advanced kidney disease or liver damage, your body might not handle it well. Pregnant women or those planning pregnancy should avoid it—there’s not enough safety data yet. And while it helps many lose weight, it’s not a magic pill. You still need to eat better, move more, and stick with it. The drug works best when paired with lifestyle changes, not instead of them.

Many people think if they’re overweight, they automatically qualify. That’s not true. Doctors look at your entire health picture—not just the scale. They check your HbA1c, your blood pressure, your cholesterol, and whether you’ve tried other methods first. In India, where access to specialists can be limited, some patients try to buy semaglutide online without a prescription. That’s dangerous. The same drug that helps one person could cause serious side effects in another.

What you’ll find below are real cases and clear explanations from people who’ve been through the process. Some got approved. Others were turned down. Some tried it and quit because of side effects. Others kept going and lost 30 pounds. These aren’t ads. They’re honest stories about what semaglutide really means in everyday life—with all the rules, restrictions, and realities that come with it.