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Most commercial plans deny Wegovy for weight loss without prior authorization. BCBS plans typically require documented BMI ≥ 30 (or ≥ 27 with comorbidity), a documented lifestyle-intervention attempt, and sometimes step-therapy first.
Different endpoints. Wegovy 2.4 mg produced 14.9% mean weight loss at 68 weeks (STEP-1). Ozempic 1 mg produced 6.0% at 30 weeks (SUSTAIN-1). Not directly comparable, but the higher Wegovy dose is meaningfully more potent for weight.
Medullary thyroid carcinoma history is a contraindication to all GLP-1 receptor agonists in this class. Options shift to non-GLP-1 therapies — SGLT-2 inhibitors, metformin, or insulin depending on indication. Discuss with your endocrinologist.
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