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Questions to Ask Your Doctor About GLP-1 Medication

Thirty-one questions worth asking before and after you start a GLP-1, each one tied to something a specific FDA label, guideline recommendation or federal rule actually says, plus what a good answer sounds like.

Last verified September 14, 2026·11 sources cited·Ozempic Wegovy Zepbound

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Most “questions to ask your doctor” lists are generic filler. This one is not. Every question below traces back to something specific in an FDA label, a guideline recommendation, or a federal coverage rule, and each comes with a note on what a substantive answer sounds like.

Bring the ones that apply to you. You will not get through all thirty-one in a fifteen-minute visit.

What should I ask about whether this drug is right for me?

1. Which approved indication are you prescribing this under?

This is the question that determines everything downstream. Wegovy, Zepbound, Foundayo and Saxenda carry weight-management indications. Ozempic, Mounjaro, Rybelsus and Trulicity are approved only for type 2 diabetes [1][2][3]. If the answer is “Ozempic for weight loss,” that is an off-label use.

2. If this is off-label, what does that mean for me?

The FDA’s own framing: providers “generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate,” but “FDA has not determined that the drug is safe and effective for the unapproved use” [4]. The FDA suggests asking about approved alternatives, the evidence behind the off-label use, benefits and risks, insurance coverage and clinical trials [4].

3. Do I meet the labeled criteria, and what is my documented BMI and qualifying condition?

You want the actual numbers in your chart, because that is what a prior authorization will be built from.

4. Should we confirm excess body fat with more than BMI?

ADA’s 2026 Standards of Care recommends confirming excess adiposity with at least one anthropometric measure such as waist circumference, waist-to-hip ratio or waist-to-height ratio in addition to BMI, particularly in the BMI 25 to 34.9 range [5]. It also warns BMI misclassifies very muscular people and people with low muscle mass [5].

5. Why this drug rather than the others?

ADA recommendation 8.18 names semaglutide or tirzepatide as preferred in people with diabetes and overweight or obesity [5]. Beyond that, the honest drivers are coverage, dosing format and what other conditions the drug also treats.

What should I ask about safety before the first dose?

6. Do I have any personal or family history of medullary thyroid carcinoma or MEN 2?

Your clinician should raise this. All the injectables in this class carry a boxed warning about thyroid C-cell tumors in rodents and are contraindicated in people with that history [1][2].

7. Do I have any condition that makes this not recommended?

The labels say these drugs are not recommended in people with severe gastroparesis [1][2].

8. What about my other medicines?

Both labels warn that delayed gastric emptying can affect absorption of other oral medicines, and advise increased monitoring for drugs with a narrow therapeutic index such as warfarin [1][2]. Foundayo has a distinct interaction profile: its label caps the dosage at 9 mg once daily when taken with a strong CYP3A4 inhibitor, and advises avoiding strong CYP3A4 inducers [3].

9. Which of my current medications promote weight gain, and can any be changed?

ADA recommendation 8.15 asks clinicians to “engage other care team members to minimize use of weight-promoting medications for treatment of other conditions among adults with diabetes and obesity,” where clinically appropriate; the accompanying discussion names antipsychotics such as clozapine, olanzapine and risperidone, some antidepressants, glucocorticoids, injectable progestins, some anticonvulsants including gabapentin and pregabalin, and beta-blockers such as atenolol, metoprolol and propranolol [5]. Note that the recommendation is addressed to the care team, not to the patient: it is a question to raise, not a change to make on your own.

10. If I use oral birth control, do I need a backup method?

Zepbound’s label advises switching to a non-oral contraceptive or adding a barrier method for 4 weeks after starting and for 4 weeks after each dose escalation [1].

11. If I might become pregnant, what is the plan?

The weight-management labels say these drugs may cause fetal harm and should be discontinued when pregnancy is recognized. Wegovy’s label advises stopping at least 2 months before a planned pregnancy because of semaglutide’s long half-life [2].

12. Do I have a history of diabetic retinopathy?

Both labels say patients with a history of diabetic retinopathy should be monitored for progression [1][2].

13. What do I tell a surgeon, dentist or endoscopy team?

Both labels instruct patients to inform healthcare providers before any planned surgery or procedure, because of rare reports of pulmonary aspiration under general anesthesia or deep sedation [1][2].

What should I ask about labs and monitoring?

14. What labs are you ordering, and why?

No label mandates a pre-treatment panel. ADA’s comprehensive medical evaluation table lists A1C, a lipid profile including total, LDL and HDL cholesterol and triglycerides, liver function tests including FIB-4, spot urinary albumin-to-creatinine ratio, serum creatinine with eGFR, and a complete blood count among initial and follow-up labs [6]. The labels add specific reasons: monitor blood glucose before starting and during treatment in people with diabetes, and monitor kidney function in patients reporting side effects that could cause volume depletion [1][2].

15. How often will you see me?

ADA recommendation 8.2b says to monitor obesity-related anthropometric measurements at least annually, and to increase monitoring to at least every three months during active weight management treatment [5].

16. Will my blood sugar need watching if I take insulin or a sulfonylurea?

Both labels warn that combining with insulin or an insulin secretagogue increases hypoglycemia risk, and that reducing the dose of those medicines may be necessary [1][2].

What should I ask about dosing and titration?

17. What is the full escalation schedule for my specific product?

Wegovy injection runs 0.25 mg, 0.5 mg, 1 mg, 1.7 mg on four-week steps to maintenance at week 17 [2]. Zepbound starts at 2.5 mg for four weeks, then 5 mg, then 2.5 mg increments at minimum four-week intervals [1]. Foundayo runs 0.8 mg, 2.5 mg, 5.5 mg, then optional steps to 9 mg, 14.5 mg or 17.2 mg at minimum 30-day intervals, with 17.2 mg the maximum [3].

18. What happens if I do not tolerate a step?

Wegovy’s label says to consider delaying escalation for four weeks [2]. Zepbound’s says to consider a lower maintenance dosage if a higher one is not tolerated [1].

19. Do I have to reach the maximum dose?

No. ADA recommendation 8.20 states that “the optimal treatment dose may not be the maximum approved dose” [5].

20. What do I do if I miss a dose?

The rules differ by product. The Wegovy injection label directs giving a missed dose if the next one is more than 2 days away, skipping it if less, and reinitiating escalation at a lower dosage after 2 or more consecutive missed doses [2]. Zepbound’s label gives a 4-day window [1]; Ozempic’s gives 5 days [7]; Wegovy tablets are skipped and resumed the next day [2]; Foundayo’s label directs taking the missed dose as soon as possible without doubling up, and reinitiating escalation at a lower dosage after 7 or more consecutive missed doses [3]. Ask which rule applies to the exact product on your prescription, and check the Instructions for Use that comes with it.

21. Who trains me on the injection, and when?

Both labels require the prescriber to train the patient or caregiver on the specific device before initiation, and to retrain if the device changes [1][2].

22. If I am on a tablet, what are the timing rules?

Oral semaglutide requires an empty stomach in the morning, no more than 4 ounces of water, swallowed whole, and at least 30 minutes before food, other drinks or other oral medicines [2]. Foundayo has none of those rules [3].

What should I ask about insurance and cost?

23. Is prior authorization required, and who submits it?

Prior authorization is the norm for this class: the Medicare GLP-1 Bridge requires a prior authorization form from the prescriber [11], and on the commercial side Business Group on Health’s 2026 GLP-1 survey of 105 large employers found that only 67 percent cover GLP-1s for weight management at all, with those that do relying on utilization management such as “validating clinical eligibility via objective biometric data, requiring participation in a weight management program to receive coverage, limiting prescribing to specific providers and excluding certain medications from the formulary” [8]. The OMA and ACOFP primary care review notes that “staff training is often required to navigate the prior authorization process from insurances that do cover anti-obesity medications” [9], which is a polite way of saying not every practice is set up for it.

24. What documentation does my plan want?

Typically a diagnosis code, documented height, weight and BMI, the qualifying comorbid condition with supporting notes or labs, and a history of prior weight-loss attempts.

25. Which GLP-1 is preferred on my plan this year?

Step therapy means a plan may require one product before another, and formularies change at the plan year boundary.

26. How long does an approval last, and what does renewal require?

Reauthorization often requires evidence of a minimum percentage of weight lost. Ask what that threshold is now, not after a renewal is denied.

27. If it is denied, will you help with the appeal?

Federal rules give you 180 days from the denial notice to file an internal appeal, and the insurer must complete it within 30 days for a service you have not yet received [10]. You can authorize your doctor to file on your behalf [10].

28. What will this cost me at the maintenance dose, not the starting dose?

Manufacturer self-pay prices are set by dose, and several ladders price the starting dose lowest. Some also require refilling within a set window to keep the lower price.

What should I ask about the long term?

29. What is the plan when I reach my goal?

ADA recommendation 8.19 says obesity pharmacotherapy indicated for chronic therapy should be continued beyond reaching weight loss goals, because discontinuation often results in weight regain and worsening cardiometabolic risk factors [5]. A clinician who frames this as a short course is not describing what the guideline says.

30. What nutrition, activity and behavioral support comes with this?

ADA recommendations 8.7 through 8.8b call for nutrition, physical activity and behavioral therapy alongside medication, with high-frequency counseling of 16 or more sessions in six months where available, and structured alternatives such as remote or app-based programs where access is limited [5]. Every one of these drugs is labeled for use “in combination with a reduced-calorie diet and increased physical activity” [1][2][3].

31. What would make you change or stop this medicine?

A clear answer here tells you whether you are in a managed course of treatment or just holding a prescription.

What does a good appointment look like?

ADA describes the shape of it: person-first, nonjudgmental language; BMI plus additional adiposity measures where feasible; privacy during weighing; assessment of readiness to change; and jointly determined goals using shared decision-making [5]. Recommendation 8.6 says to individualize the initial approach among lifestyle and nutritional therapy, pharmacologic therapy and metabolic surgery based on medical history, life circumstances and preferences, and to consider combining them [5].

If you leave without knowing which indication you are being treated under, what your escalation schedule is, and whether your plan will pay, the appointment is not finished.

Nothing in this article tells you what to take or what to change. It summarizes what specific FDA-approved prescribing information, Instructions for Use, guideline recommendations and federal rules say, so that the person who can answer has what they need. Your own prescription, your product’s Instructions for Use and your provider govern what you actually do.

Sources

Questions people ask

What is the single most important question to ask?

"Which approved indication am I being prescribed this under?" The answer determines whether the prescription is on-label, whether your insurance is likely to cover it, and which dose ladder applies. Ozempic and Mounjaro are approved only for type 2 diabetes; Wegovy, Zepbound, Foundayo and Saxenda carry weight indications.

What labs should I expect before starting?

No FDA label requires a specific pre-treatment panel, and no guideline publishes a single mandatory one. In practice clinicians commonly check A1C or fasting glucose, a lipid panel, liver enzymes, kidney function with eGFR, and a complete blood count, which mirrors the ADA's comprehensive medical evaluation table. Pregnancy testing applies where relevant.

Should I ask about family history of thyroid cancer?

Your clinician should ask you. Every drug in this class is contraindicated in people with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. If nobody asked, raise it.

What should I ask about insurance before I leave the appointment?

Whether prior authorization is required, what documentation the plan wants, how long an approval lasts, what renewal requires, and whether a different GLP-1 is preferred on your formulary. Prior authorization is standard for this class, and plans commonly set criteria stricter than the FDA label.

Is it rude to ask about cost?

No, and skipping it is the most expensive mistake in this category. Because guidelines expect treatment to continue past your goal weight, the right budgeting unit is a year, not a month. Self-pay prices are also set by dose, so the starting dose price is usually not the maintenance price.

What should I ask if I have to stop or pause?

Ask what to do about missed doses for your specific product, since the rules differ, and what happens if coverage lapses. Wegovy's label says that after two or more consecutive missed injections, escalation is restarted at a lower dose.

What questions matter at the follow-up rather than the first visit?

Whether to step up the dose, how tolerability is trending, what the plan is for nutrition and activity support, and when reauthorization is due. ADA recommends increasing monitoring to at least every three months during active weight management treatment.

Should I ask about stopping the medication eventually?

Yes, and expect a specific answer. ADA recommendation 8.19 says obesity pharmacotherapy indicated for chronic therapy should be continued beyond reaching weight loss goals, because stopping often results in weight regain and the return of cardiometabolic risk factors.

This article summarizes FDA labeling, published research and company information current as of September 14, 2026. It is not medical advice and does not replace a conversation with your own healthcare provider. How we research and verify.