Table of Contents
- Overview
- Use in Type 2 Diabetes
- Use in Obesity and Weight Management
- Cardiovascular Risk Reduction
- Off-Label and Emerging Uses
- Eligibility Criteria
- Scientific References
Overview
GLP-1 receptor agonists are approved by the FDA for two primary conditions: type 2 diabetes and chronic weight management. They may also be used for cardiovascular benefit in certain populations. Understanding these indications helps determine who can benefit most from this class of medication.
Use in Type 2 Diabetes
Most GLP-1 medications were originally developed for the treatment of type 2 diabetes. They help lower A1C, support weight loss, and reduce postprandial glucose spikes. GLP-1 therapy may be appropriate for people with:
- Type 2 diabetes with inadequate control on oral medications
- High A1C despite metformin or lifestyle changes
- Need to reduce risk of hypoglycemia
- Desire for weight loss in addition to glycemic control
Use in Obesity and Weight Management
Several GLP-1 medications—such as Saxenda® and Wegovy®—are approved for chronic weight management. Candidates typically meet one of the following:
- BMI ≥30 (obese)
- BMI ≥27 with at least one weight-related comorbidity (e.g., hypertension, dyslipidemia, sleep apnea)
GLP-1 therapy may be especially helpful for those who struggle with appetite control and portion sizes.
Cardiovascular Risk Reduction
Some GLP-1 medications (e.g., liraglutide, semaglutide, dulaglutide) are indicated for reducing cardiovascular events in adults with type 2 diabetes and established heart disease. This includes patients with:
- Type 2 diabetes
- History of heart attack, stroke, or other atherosclerotic disease
Off-Label and Emerging Uses
In clinical practice, GLP-1s may sometimes be prescribed off-label for weight loss even when patients do not meet the strict FDA BMI criteria, particularly under the care of an obesity medicine specialist. Research is also exploring GLP-1 use in:
- Polycystic ovary syndrome (PCOS)
- Prediabetes and insulin resistance
- Non-alcoholic fatty liver disease (NAFLD/NASH)
Eligibility Criteria Summary
| Condition | Eligibility Criteria | Approved Medications |
|---|---|---|
| Type 2 Diabetes | A1C above goal despite lifestyle and oral medications | Ozempic®, Trulicity®, Victoza®, Rybelsus®, etc. |
| Obesity | BMI ≥30 or BMI ≥27 with comorbidity | Saxenda®, Wegovy® |
| Cardiovascular Risk | Type 2 diabetes with existing ASCVD | Ozempic®, Trulicity®, Victoza® |
Scientific References
- American Diabetes Association. “Pharmacologic Approaches to Glycemic Treatment.” Diabetes Care. 2024;47(Suppl 1):S125–S143.
- Wilding JPH, et al. “Once-Weekly Semaglutide for Weight Loss.” NEJM. 2021;384:989–1002.
- FDA Labeling for Wegovy®, Saxenda®, and Ozempic®. Updated 2024.
- Rubino DM et al. “Weight Reduction with GLP-1 RAs in Obesity Management.” Obesity. 2023;31(5):892–903.
This content is part of the GLP-1 Basics section of the American Center for GLP-1 Nutritional Guidance (ACGNG). It is not a substitute for medical advice. Consult your provider to determine individual eligibility.