Prescription weight loss medication is not handed out on request. There is a clinical assessment process that every doctor — whether in a traditional clinic or telehealth setting — works through before deciding whether to prescribe.

Understanding what that assessment covers helps you prepare for the conversation and gives you a clearer sense of what to expect.

BMI and Weight History

The starting point is almost always BMI and weight history. Most prescribing guidelines for weight loss medication nz require a BMI of 30 or above, or 27 or above in the presence of at least one weight-related health condition.

Your doctor will also want to understand your weight history — how long you have been at your current weight, whether there have been significant fluctuations, and what factors have driven changes. This provides context that makes the clinical picture more complete.

Existing Health Conditions

Some conditions make weight management medication more likely to be beneficial, while others may preclude certain medications entirely. Your doctor will review:

·         Type 2 diabetes or insulin resistance

·         Cardiovascular conditions — hypertension, high cholesterol, history of heart disease

·         Sleep apnoea

·         Polycystic ovary syndrome (PCOS)

·         Thyroid conditions — some may contraindicate GLP-1 medications

·         Kidney and liver function

·         Gastrointestinal conditions such as gastroparesis

Previous Weight Loss Attempts

Prescription medication is generally considered after lifestyle-based approaches have been tried. Your doctor will ask about your history with diet changes, physical activity, and any structured programmes you have attempted.

This is not a gatekeeping exercise — it is about establishing that medication is being used as a genuine clinical intervention rather than a first resort.

Current Medications

Drug interactions are a genuine consideration. GLP-1 medications can affect the absorption of other oral medications due to their effect on gastric emptying. Your doctor needs a full picture of what you are currently taking, including supplements.

Lab Results

Many prescribers will want recent blood tests before initiating treatment — particularly kidney function, liver enzymes, HbA1c, and thyroid markers. If you have recent results, bring them. If not, the prescriber may request them before proceeding.

A Note on Telehealth Assessments

The same clinical considerations apply whether you see a GP in person or through a telehealth platform. A responsible online prescriber will conduct a thorough assessment and may decline to prescribe if the clinical picture does not support it.