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Based on current clinical guidelines and our patient experience: Strong indication: BMI ≥30 (obesity) without active contraindications BMI ≥27 (overweight) with weight-related comorbidities such as hypertension, dyslipidaemia, type 2 diabetes, sleep apnoea, or fatty liver disease Patients who have attempted weight management through diet and exercise without sustained results Patients who have plateaued with other weight management interventions Relative indication (clinical judgement): BMI 25-27 with specific metabolic drivers (pre-diabetes, insulin resistance, PCOS) Patients preparing for weight-related surgery or other medical interventions Patients with specific body composition goals beyond BMI criteria Not indicated or contraindicated: Pregnancy, breastfeeding, or pregnancy planning within next 2 months Personal or family history of medullary thyroid cancer or MEN2 syndrome Personal history of pancreatitis Active severe gastroparesis or severe gastrointestinal disease BMI below 25 (cosmetic use for body contouring in normal-weight individuals is not appropriate) Eating disorder history — GLP-1 use can be problematic for patients with restrictive eating patterns Frequently asked questions Is Ozempic "better" for weight loss than Wegovy
