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11 editorial guides covering on-label and emerging uses. Evidence summary, prescribing reality, and insurance pathway for each indication.
Zepbound is the only FDA-approved GLP-1 for OSA with obesity (December 2024). The OSA pathway is currently the cleanest route to weight-loss GLP-1 coverage for many insurance plans.
Wegovy (semaglutide 2.4 mg) became the first GLP-1 FDA-approved for fatty liver disease in March 2026 — for F2-F3 non-cirrhotic MASH, based on the ESSENCE trial. Other GLP-1s show benefit but remain off-label.
Semaglutide reduces kidney disease progression in T2D patients with CKD. FLOW trial (2024) supports broader use. Mounjaro shows similar signals.
Wegovy is FDA-approved for cardiovascular risk reduction in adults with established cardiovascular disease and BMI ≥ 27. The 2026 Medicare cardiovascular pathway opens coverage.
GLP-1s slow gastric emptying intentionally. Patients with preexisting gastroparesis or significant motility disorders should not use GLP-1s. Anesthesia preoperative protocols increasingly require GLP-1 hold.
T2D is the original on-label GLP-1 indication. Ozempic, Mounjaro, Rybelsus, and Trulicity are FDA-approved to improve glycemic control in adults with type 2 diabetes — Wegovy and Zepbound are not (they are obesity-indication brands of the same molecules).
Weight loss is the core on-label GLP-1 indication. Wegovy (semaglutide) and Zepbound (tirzepatide) are FDA-approved for chronic weight management at BMI ≥ 30, or ≥ 27 with a weight-related comorbidity.
Wegovy is FDA-approved to reduce major adverse cardiovascular events in adults with established cardiovascular disease and BMI ≥ 27, with or without diabetes. It is the strongest insurance pathway in the category and the only realistic Medicare route in 2026.
PCOS is the most-asked off-label GLP-1 indication. Weight loss, insulin sensitivity, and androgen levels often improve, but FDA approval is not on-label.
No GLP-1 is FDA-approved for prediabetes, but trials show 60-70% reduction in T2D progression at 3 years. The case for early intervention is strong.
Menopause-driven weight gain responds to GLP-1s similarly to other adult obesity. No menopause-specific indication exists, but real-world data show comparable efficacy.