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Guide 4 of 9 · Stage: Decide

Should I consider a GLP-1 medicine? And when not to

Who Health Canada labels and the Canadian obesity guideline consider these medicines for, who pays, who should not take them, and how to prepare for an honest talk with a doctor.

GLP Guidebook teamUpdated 12 Oct 202615 min read33 sourcesWritten from published sources
The short answer

In Canada, GLP-1 medicines are approved for type 2 diabetes, and some brands for obesity or overweight that affects your health. Provincial drug plans cover some of them for diabetes, but none for weight management, so paying is often the hardest part. Meeting a number does not mean you should take one. Some people should not take them at all. Talk to a doctor before starting, stopping or changing any medicine.

Key facts

Names you'll see
  • Wegovy and Ozempic contain semaglutide; Ozempic is approved for type 2 diabetes only8,1
  • Zepbound and Mounjaro contain tirzepatide; Mounjaro is approved for type 2 diabetes only9,1
The label
Adults with a BMI of 30 or more, or 27 to 29.9 with at least one weight-related condition8,9
Who pays
No provincial plan covers them for weight (as of 12 Oct 2026). Ozempic and its generics are covered for type 2 diabetes, with conditions.10,11
That is not a yes
The Canadian guideline pairs every medicine with health behaviour changes, and a doctor weighs it up with you2
Never take it if
You or family had medullary thyroid cancer, you have MEN2, you're allergic, or you're pregnant2,3
Results vary
In the main trials, 9 to 14 in 100 people lost less than 5% of their weight; about 31 in 100 if they had type 2 diabetes21,22,23
When you stop
Most of the weight lost tends to come back within a year24
Prescription
Always. All GLP-1 medicines are prescription drugs in Canada1
On this page
  1. What do doctors look at?
  2. Who pays: provincial plans, private insurance and Quebec
  3. Who should not take a GLP-1?
  4. What about pregnancy, PCOS and the pill?
  5. Teens, older adults, kidneys, liver, other medicines, surgery
  6. What if I only want to lose a few kilos?
  7. What results can I honestly expect?
  8. A way to think it through
  9. What to bring to the doctor
  10. What support comes with it?
  11. Questions people ask

What do doctors look at?

Doctors look at your weight, your waist, your health conditions, and what you've already tried. A BMI number alone does not decide it.

BMI (body mass index) is your weight in kilograms divided by your height in metres squared. Two different sets of numbers get mixed up online. One set describes your weight. The other is where a doctor may start to think about medicine. They are not the same thing.

Describes your weight Canadian BMI ranges

The Canadian guideline uses: healthy 18.5 to 24.9, overweight 25 to 29.9, obesity 30 or more.4 For adults of South, Southeast or East Asian background, overweight starts at 23.4 Waist size matters too. Guide 1 explains this.

Where a doctor may consider medicine The label and the guideline

Wegovy and Zepbound are approved for weight management in adults with a BMI of 30 or more, or 27 to 29.9 with at least one weight-related condition, like high blood pressure, type 2 diabetes or sleep apnoea.8,9 The Canadian guideline uses the same numbers, but asks doctors to also use ethnicity-specific BMI and waist measures, so some people below these lines may still be considered.2

Meeting a number does not mean you should take it. The label is the outer limit of what a prescriber may consider, not a promise. The Canadian guideline says the choice should fit your values, goals, health and budget, and that the aim is better health, not just weight loss.2 It recommends against using compounded products or medicines not approved in Canada for weight loss.2

Type 2 diabetes is a separate reason. Ozempic is approved in Canada to control blood sugar in type 2 diabetes, and to lower heart and kidney risk in some people with diabetes. That approval has no weight cut-off.1 Diabetes Canada says metformin should usually come first, and recommends a GLP-1 medicine or SGLT2 inhibitor with proven benefit for people with heart disease.20 Your doctor will look at your HbA1c (often written A1C; a blood test of your average sugar level over about 3 months) and your other medicines.

Other approved uses exist. Wegovy is approved to lower the risk of a non-fatal heart attack in adults with heart disease and a BMI of 27 or more, and its label added fatty liver disease with scarring (MASH) in October 2026, under a conditional approval.8 Zepbound is approved for moderate to severe sleep apnoea in adults with obesity.9

Who can prescribe. A family doctor or nurse practitioner can prescribe them; you don't need a specialist.12 In Alberta, pharmacists with additional prescribing authorization can prescribe too, though we found no specific guidance on starting GLP-1s for weight.13 Doctors who see you online must meet the same standard of care as in person.31 Guide 6 explains the routes.

Who pays: provincial plans, private insurance and Quebec

Each province and territory runs its own drug plan. For weight management, none of them pays. For type 2 diabetes, most cover semaglutide with conditions. Checked 12 Oct 2026.

For weight management

In July 2025, Canada's Drug Agency (CDA-AMC), which advises public plans, recommended paying for Wegovy only for adults with a BMI of 27 or more and established heart disease, and only if the price fell by about two-thirds.10 Price talks for the public plans ended without agreement on 1 December 2025, after Novo Nordisk said it would no longer seek public coverage of Wegovy.11 Quebec also declined to list Wegovy.14 We found no public plan that covers Zepbound or Saxenda for weight. See why no province covers Wegovy or Zepbound.

For type 2 diabetes

PlanWhat we found
Ontario (Ontario Drug Benefit)Semaglutide pens and Rybelsus are "Limited Use": for adults whose blood sugar isn't controlled on the highest dose of metformin they can take, or who can't take metformin. Generic semaglutide is listed as interchangeable, and the plan pays the generic price.15
British Columbia (PharmaCare)Special Authority after inadequate control on metformin, up to 1 mg a week (the 2 mg dose was under review). BC's national pharmacare plan, launched March 2026, does not include semaglutide.16
AlbertaOzempic is covered under step therapy or special authorization. Generic semaglutide was added for type 2 diabetes from 1 July 2026.17
Quebec (RAMQ)Ozempic is an exception drug (médicament d'exception), covered with metformin when a sulfonylurea can't be used, isn't tolerated or hasn't worked. Mounjaro is not on the RAMQ list.18
First Nations and Inuit (NIHB)Ozempic and Rybelsus are Limited Use, for type 2 diabetes not controlled on metformin or other diabetes medicines.18
Tirzepatide (Mounjaro)We found no province that covers it. BC was considering it for type 2 diabetes in 2026.19

Other provinces and territories were not checked one by one. Plans change often; ask your pharmacist what your plan covers.

Private insurance

Only a small number of private insurers cover these medicines for weight management.25 Plans that do often ask for prior authorization (a form your doctor fills in), a BMI threshold, or step therapy, meaning you try other options first.26 Ozempic for diabetes is usually treated as a diabetes drug by insurers.26 Check your plan booklet or call your insurer before you start. See private insurance and GLP-1s.

Quebec is different. In Quebec, everyone must have drug insurance. If you can join a private group plan through work (assurance collective), you must; everyone else is covered by RAMQ's public plan (régime public d'assurance médicaments).27 See Ozempic in Quebec.

Who should not take a GLP-1?

Some people should never take these medicines. Others need extra care, and a doctor may decide it isn't safe for them.

The Canadian guideline lists firm "do not take" groups: anyone with a personal or family history of medullary thyroid cancer (MTC), or a personal history of a rare inherited condition called MEN2 (multiple endocrine neoplasia type 2), and anyone who is pregnant, trying to conceive or breastfeeding.2 The labels add anyone with a serious allergy to the medicine.3

The thyroid warning comes from animal studies. Semaglutide caused thyroid tumours in rodents. Nobody knows yet whether it does the same in people.3

The table below lists the main conditions. "Do not take" means it's listed as a firm reason not to use the medicine. "Not recommended" means the label advises against it. "Caution" means a doctor may still prescribe, but watches you more closely.

ConditionWhy it mattersWhat it means
You or a close relative had medullary thyroid cancer, or you have MEN2Thyroid tumours seen in animal studies; human risk unknown3Do not take Listed as a contraindication2,3
Allergy to the medicine or its ingredientsSevere allergic reactions have been reported3Do not take3
Pregnant, or trying to get pregnantMay harm the baby3Stop Stop semaglutide at least 2 months before trying2
BreastfeedingNot recommended while breastfeeding2,5Do not use per the Canadian guideline2
Past pancreatitis (swollen pancreas)Pancreatitis, sometimes fatal, has happened on these medicines3Caution European label advises caution5
Severe gastroparesis (very slow stomach) or bowel diseaseStomach side effects can be more severe3,5Not recommended if severe Caution with inflammatory bowel disease5
Gallbladder problemsGallstones are more common on these medicines3,2Tell your doctor Mention any past gallstones3
Type 1 diabetesWegovy has not been studied in people with type 1 diabetes3,5Not recommended for weight (European label)5
Severe kidney diseaseLittle experience; vomiting and diarrhea can dry you out and harm kidneys3,5Specialist decision See kidneys below
Severe liver diseaseLittle experience in severe liver impairment5Not recommended for weight (European label)5
Diabetic eye disease (retinopathy)Eye complications reported in people with type 2 diabetes3Caution Needs eye check-ups3
Severe heart failureNot studied in the most severe stage5Not recommended for weight (European label)5
Eating disorder, now or in the pastStrong appetite effects may make disordered eating worse28Tell your doctor Not on the labels, but researchers flag it28

From the Canadian obesity guideline, the US Wegovy and Zepbound labels and the European Wegovy label. Your own pack comes with the Canadian product monograph's patient information; read it before you start.

What about pregnancy, PCOS and the pill?

Don't take a GLP-1 while pregnant. If you could get pregnant, plan contraception with your doctor before you start.

These medicines stay in the body for a while after the last dose. So the makers recommend stopping them before a planned pregnancy: at least 2 months before for semaglutide (Wegovy, Ozempic), and at least 1 month before for tirzepatide (Zepbound, Mounjaro).2

Tirzepatide can make the contraceptive pill less reliable. It slows the stomach, which can affect how well the pill is absorbed. The effect is largest after the first dose.6

If you take the pill with Zepbound or Mounjaro, the Canadian guideline advises switching to a method you don't swallow, or adding a barrier method such as a condom, for 4 weeks after starting and for 4 weeks after each dose increase.2 Methods that aren't swallowed, like a hormonal IUD, are not affected.6

Semaglutide is not expected to make the pill less effective, according to its European label.5

PCOS note. If you have PCOS (polycystic ovary syndrome) and take the pill, the advice above applies to you.2,6 Tell your doctor before starting, especially on tirzepatide, and plan contraception at the same visit.

Teens, older adults, kidneys, liver, other medicines and surgery

These groups can sometimes use GLP-1 medicines. But each one needs extra checks, and some need a specialist.

Teenagers

In Canada, Wegovy is approved for weight management from age 12, for teens with obesity who weigh over 60 kg (132 lb), alongside diet and activity. Saxenda is also approved from 12.8,1 The European label says to stop and rethink if a teen's BMI hasn't dropped by at least 5% after 12 weeks on the full dose.5 Gallstones were more common in teens than adults on Wegovy.3 Zepbound's Canadian approval for weight is for adults only; Mounjaro is approved from age 10 for type 2 diabetes.9,1

Older adults

Older people can lose muscle along with fat, which raises the risk of frailty. Direct evidence in older adults is scarce.29 In the SELECT trial of Wegovy, people aged 75 and over had more hip and pelvis fractures than on a dummy injection: 2.4 in 100 against 0.6 in 100.2 Dehydration from vomiting or diarrhea can harm the kidneys, so drinking enough matters.3

Kidney disease

Kidney injury has been reported, mostly in people who got dehydrated from stomach side effects.3 The European label does not recommend Wegovy if kidney function is very low (an eGFR blood-test result below 30).5 But in people with type 2 diabetes and kidney disease, Ozempic is approved in Canada to lower the risk of kidney decline, kidney failure and heart-related death.1 So this is a decision for your kidney or diabetes doctor.

Liver disease

Wegovy's Canadian label added fatty liver disease with scarring (MASH) in October 2026, under a conditional approval.8 It is not recommended in severe liver impairment, and needs caution in milder cases.5

If you take insulin or a sulfonylurea

Sulfonylureas are diabetes tablets like gliclazide and glimepiride. Taken with a GLP-1, they and insulin raise the risk of low blood sugar (a hypo), including severe hypos.3 Your doctor may lower their dose when you start, and should explain the signs of a hypo.3

Before surgery or an endoscopy (camera test)

GLP-1 medicines slow your stomach. Rarely, food has stayed in the stomach despite fasting, and been breathed into the lungs under anaesthetic.3,2 Always tell the surgeon and anaesthesiologist you take one.3

US guidance from 2024 says most people can keep taking it before planned surgery. Higher-risk people may need a liquid-only diet for 24 hours first. That includes people in the early dose-increase weeks, on higher doses, or with stomach symptoms.30 Your hospital team in Canada may have its own advice; follow theirs.

What if I only want to lose a few kilos?

These medicines are not meant for a few kilos before a wedding or a holiday, or for losing fat for bodybuilding. You'd take on the same risks with no proven benefit.

It's not what they are approved for. The weight approvals cover obesity, or overweight with a weight-related condition.8,9 The big trials only included people with obesity or overweight with a condition.21,22

The risks don't shrink because your goal is small. Stomach side effects, gallstones and pancreatitis can still happen.3

The weight tends to come back. A year after stopping semaglutide, people had regained about two-thirds of what they'd lost.24 A short course before an event is likely to be undone afterwards.

Some of what you lose is muscle. In studies, muscle made up as much as a quarter of the weight lost.29 That works against a gym goal.

Fakes are a real risk in Canada. Health Canada warns about fake and unauthorized Ozempic and Mounjaro sold in stores and online, some using fake logos and endorsements.7 In August 2025 it warned that "research peptide" tirzepatide and retatrutide sold online were illegal.32 Buy only from a licensed pharmacy, and check the 8-digit DIN on the label.7

What to read instead. Guide 3: Your options covers food, activity and other routes. The few-kilos path pulls it together.

What results can I honestly expect?

Most people in trials lost a meaningful amount of weight. But results vary a lot, side effects are common, and the weight returns if you stop.

Before the numbers, how these trials work:

  • People are put into groups at random.
  • One group gets the medicine. The other gets a dummy injection (a placebo) that looks the same but has no medicine in it.
  • Both groups get the same advice on diet and activity.
  • The gap between the groups is what the medicine added.

Trials use losing 5% of body weight as a key marker.21,22 For someone who starts at 90 kg (198 lb), that's 4.5 kg (about 10 lb). Out of every 100 people in each trial, this is how many reached it:

STEP 1Semaglutide 2.4 mg (Wegovy), weekly

Adults without diabetes, 68 weeks.21

Semaglutide86 in 100
Dummy injection31 in 100
SURMOUNT-1Tirzepatide 15 mg (the Zepbound dose), weekly

Adults without diabetes, 72 weeks.22

Tirzepatide91 in 100
Dummy injection35 in 100
STEP 2Semaglutide 2.4 mg (Wegovy), weekly

Adults with type 2 diabetes, 68 weeks.23

Semaglutide69 in 100
Dummy injection28 in 100

These are separate trials with different people, so they can't be compared with each other.

Put the other way, about 1 in 7 people on semaglutide and 1 in 11 on tirzepatide lost less than 5%. With type 2 diabetes, it was nearly 1 in 3.21,22,23

If you stop, most of it comes back. A year after stopping semaglutide, people had regained about two-thirds of the weight they'd lost.24

Side effects make some people stop. In the semaglutide trial, 4.5 in 100 people quit because of stomach side effects, against 0.8 in 100 on the dummy. This count includes only stomach side effects.21 On tirzepatide 15 mg, 6.2 in 100 stopped because of any side effect, against 2.6 in 100.22 So the two numbers measure different things.

People with diabetes tend to lose less. The average was 9.6% of body weight in the diabetes trial, against 14.9% in people without diabetes.23,21

Expect a review. The Canadian guideline notes that regulators have traditionally advised stopping if 5% hasn't been lost after 3 months on a full dose, but says real health gains can come whatever the amount lost. You and your doctor judge it against your own goals.2

Think of it as long-term. The Canadian guideline recommends using these medicines long term when they work, because stopping tends to bring the weight and health problems back.2 Guide 9 covers stopping.

Cost adds up if you pay yourself. Guide 6 gives official prices and explains coverage.

A way to think it through

Use this to sort your thoughts before a doctor visit. It does not give you a yes. Only a doctor who knows your health can.

1Is it for a health reason? Type 2 diabetes, or weight that affects your health?
If noA few kilos, or an event? These medicines aren't for that. Read Guide 3.
2Does anything in the "should not" table apply to you?
If yesDon't start. Tell the doctor; it may rule the medicine out.
3Are you pregnant, breastfeeding, or planning a baby soon?
If yesNot now. Plan timing and contraception with a doctor.
4Are you ready for long-term use, the side effects and, if your plan doesn't cover it, the cost?
If unsureRead Guide 5 and Guide 6 first.
Talk it through with your family doctor or nurse practitioner.Take the checklist below. The prescriber decides whether a medicine fits you, and which one.

Questions to ask yourself

There's no score here. These questions help you know what you want, and what you're ready for.

  • Why do I want this now? Is it my health, or pressure from others?
  • What have I tried before? What worked, even for a while?
  • Could I keep taking a medicine for years, not months?
  • Does my drug plan or insurance cover it? If not, could I pay for a year or more?
  • How would I cope with feeling sick or having an upset stomach for a few weeks?
  • Am I planning a pregnancy in the next year or two?
  • Have I ever struggled with an eating disorder, like bingeing or starving myself?
  • Who will support me with food changes and activity?

What should I bring to the doctor?

Bring your history, your medicines, your insurance details and any recent test results. Then ask the questions below. You can print this card.

My GLP-1 doctor visit

Bring

  • Your weight history: highest weight, recent changes, past attempts
  • Your waist size, if you've measured it
  • Your ethnic background, if it changes the BMI and waist numbers used for you
  • A list of every medicine and supplement you take, with doses
  • Recent test results, if you have them: A1C, cholesterol, liver, kidney and thyroid tests
  • Family history: thyroid cancer, MEN2, pancreatitis, diabetes
  • Your own history: pancreatitis, gallstones, stomach problems, eating disorders, eye disease
  • Pregnancy plans, and the contraception you use
  • Your provincial plan and any private insurance details
  • Any surgery or endoscopy (camera test) you have planned

Ask

  • Is a medicine right for me, or should I try something else first?
  • Is this medicine approved in Canada for my condition, or would it be off-label?
  • Will my plan or insurance cover it? Do you need to fill in a form?
  • How will we check if it's working, and when?
  • What should I do about my other medicines?
  • Which side effects mean I should call you, 811 or 911?
  • What happens if I stop?
  • Who do I contact between visits?

From GLP Guidebook, Guide 4. General information, not medical advice.

Your family doctor or nurse practitioner is usually the first step. If you don't have one, 811 in most provinces can tell you where to go. Guide 6 explains in-person and online prescribing, coverage and safe ways to fill a prescription. Our doctor visit checklist builds a fuller list.

What support comes with it?

The Canadian guideline recommends every weight medicine alongside health behaviour changes, with help from a registered dietitian where available.

It says adults living with obesity should get personalised nutrition advice from a registered dietitian when one is available, and that behaviour-change support belongs in every plan.2,33 Ask what your doctor's clinic, your province or your insurance plan offers.

Whatever route you take, it helps if someone at home knows what you're taking, which side effects to expect, and when to get help.

Questions people ask

My BMI is 28. Can I get a GLP-1?

There's no automatic "yes". The Canadian labels let a prescriber consider Wegovy or Zepbound from a BMI of 27 if you also have a weight-related condition, like high blood pressure or type 2 diabetes.8,9 Paying is the other question: no provincial plan covers them for weight, and private plans have their own rules.11,26 Either way, it's a decision a prescriber makes with you, after weighing the risks.

Does my ethnic background change anything?

It can. The Canadian guideline starts overweight at a BMI of 23 for South, Southeast and East Asian adults, uses lower waist cut-offs, and asks doctors to use these ethnicity-specific measures when deciding about medicine.4,2 The medicines' labels use the same numbers for everyone.8,9

Can a pharmacist prescribe it?

In Alberta, pharmacists with additional prescribing authorization can prescribe, start or stop medicines, but we found no specific guidance on GLP-1s for weight.13 Elsewhere, a family doctor or nurse practitioner usually prescribes. See can a pharmacist prescribe Ozempic in Canada?

Can I take it if my mother had thyroid problems?

Most thyroid problems, like an underactive thyroid, are not on the "do not take" list. The ban is for a personal or family history of medullary thyroid cancer, or MEN2.2,3 Tell your doctor exactly what your relative had.

Is it safe with metformin?

Metformin is not one of the medicines the labels flag for low blood sugar. That warning is about insulin and sulfonylureas like gliclazide.3 In Canada, GLP-1s for diabetes are usually added to metformin.20 Your doctor will still review all your medicines together.

How long would I need to take it?

Often for a long time. In the stopping study, most of the weight came back within a year.24 The Canadian guideline recommends long-term use when the medicine is working.2

Can I stop before I try for a baby?

Plan it with your doctor. The makers recommend stopping semaglutide at least 2 months, and tirzepatide at least 1 month, before a planned pregnancy.2

I'm having surgery next month. Should I stop?

Don't decide alone. Tell your surgeon, anaesthesiologist and the person who prescribed it. Since 2024, US guidance says most people can continue, with extra steps for higher-risk people.30

Before you move on

  • A BMI number is where a doctor may start thinking, not a reason to take a medicine.
  • No provincial plan covers them for weight; check your private plan before you start.
  • Never take one with a personal or family history of MTC or MEN2, or in pregnancy.
  • On tirzepatide, add a condom to the pill for 4 weeks after starting and 4 weeks after each dose increase.
  • They're not for a few kilos, and weight usually returns after stopping.
  • You have a checklist to take to your family doctor or nurse practitioner.
Your optionsGetting a prescriptionStoppingFor a family member
Was this guide easy to understand?

Sources

  1. Health Canada. Drug Product Database and product monographs: Ozempic (PM 13 July 2026: type 2 diabetes, heart and kidney risk reduction), Mounjaro (PM 23 June 2026: type 2 diabetes in adults and ages 10 to under 18), Saxenda (adolescents 12 to under 18), all "Prescription". Searched 12 October 2026. health-products.canada.ca
  2. Pedersen SD, Manjoo P, Dash S, Jain A, Pearce N, Poddar M. Canadian Adult Obesity Clinical Practice Guideline: Pharmacotherapy for Obesity Management in Adults, 2025 update. Obesity Canada, Version 3, 11 August 2025 (recommendations 1–13; contraindications; pregnancy, contraception, fracture and anaesthesia notes; review after 3 months). obesitycanada.ca (PDF)
  3. Novo Nordisk. Wegovy (semaglutide) US prescribing information, revised June 2026: boxed warning, sections 4, 5, 8. PDF
  4. Rueda-Clausen CF, Poddar M, Lear SA, Poirier P, Sharma AM. Canadian Adult Obesity Clinical Practice Guidelines: Assessment of People Living with Obesity. Obesity Canada, Version 1, 4 August 2020 (Table 1 BMI classification; Table 2 waist cut-offs). obesitycanada.ca (PDF)
  5. European Medicines Agency. Wegovy summary of product characteristics: sections 4.1, 4.2, 4.4, 4.5, 4.6. PDF
  6. Eli Lilly. Zepbound (tirzepatide) US prescribing information, revised August 2026: sections 4, 7, 8.3, 8.4. PDF
  7. Health Canada. Thinking about buying GLP-1 drugs like Ozempic or Mounjaro? Beware of fake or unauthorized products (advisory RA-81518), updated 21 January 2026. recalls-rappels.canada.ca
  8. Novo Nordisk Canada. Wegovy (semaglutide injection) Product Monograph, revised 2 October 2026 (adults: BMI 30 or more, or 27 or more with at least one weight-related comorbidity; adolescents 12 to under 18 above 60 kg; non-fatal heart attack risk; MASH under the NOC/c policy). Health Canada Drug Product Database
  9. Eli Lilly Canada. Zepbound (tirzepatide injection) Product Monograph, 11 June 2026 (adults: BMI 30 or more, or 27 to under 30 with a weight-related comorbidity; obstructive sleep apnoea in adults with obesity). Health Canada Drug Product Database
  10. Canada's Drug Agency (CDA-AMC). Semaglutide (Wegovy) reimbursement recommendation SR0841, July 2025 ("Reimburse with conditions" for adults with BMI 27 or more and established cardiovascular disease; "A price reduction of 67% would be required"). canjhealthtechnol.ca
  11. BC PharmaCare. Drug coverage decision: semaglutide (Wegovy), 18 December 2025 ("Non-benefit"; Novo Nordisk "would no longer be seeking public coverage of Wegovy in Canada"; pCPA negotiations concluded without agreement on 1 December 2025). gov.bc.ca (PDF)
  12. Canada's Drug Agency (CDA-AMC). Semaglutide (Wegovy) review SR0841, clinician input: "any health care provider with experience managing obesity could prescribe semaglutide … not … restricted to specialists alone". canjhealthtechnol.ca
  13. Alberta College of Pharmacy. Additional prescribing authorization matters for safe pharmacy practice in Alberta, 24 February 2026 (APA pharmacists can prescribe "at initial access, for managing ongoing care, or to deprescribe"). abpharmacy.ca
  14. INESSS. Wegovy: amélioration des paramètres cardiométaboliques (IMC ≥ 35 kg/m²), "Refus d'inscription"; Minister's decision "Ne pas inscrire", 4 March 2026. inesss.qc.ca
  15. Ontario Ministry of Health. Ontario Drug Benefit Formulary: semaglutide pens and Rybelsus listed as Limited Use; generic semaglutide interchangeable (checked 12 October 2026); Limited Use criteria from the Executive Officer notice, January 2024. formulary.health.gov.on.ca
  16. BC PharmaCare. Limited coverage drugs: semaglutide (Special Authority; up to 1 mg weekly; 2 mg under review), updated 21 April 2026; and BC national pharmacare plan (Plan NP) coverage list. gov.bc.ca
  17. Alberta Blue Cross. Pharmacy Benefact 1330, July 2026 ("Effective July 1, 2026, generic semaglutide products were added to the ADBL for the treatment of type 2 diabetes"). ab.bluecross.ca (PDF)
  18. Diabète Québec. Table of diabetes medications and their coverage (RAMQ, private insurance, NIHB), March 2026. RAMQ's own site could not be checked directly. diabete.qc.ca (PDF)
  19. BC PharmaCare. Your Voice: tirzepatide (Mounjaro) for type 2 diabetes, drug information, public input 25 February to 24 March 2026. gov.bc.ca (PDF)
  20. Lipscombe L et al.; Diabetes Canada Clinical Practice Guidelines Expert Committee. Pharmacologic glycemic management of type 2 diabetes in adults: 2020 update. Can J Diabetes 2020;44:575–91. diabetes.ca
  21. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). NEJM, 2021;384:989–1002. DOI
  22. Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity (SURMOUNT-1). NEJM, 2022;387:205–216. DOI
  23. Davies M et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet, 2021;397:971–984. DOI
  24. Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab, 2022;24:1553–1564. DOI
  25. Global News. Novo Nordisk to cut Ozempic price as generics arrive ("only a small number of private insurers cover the use of the drugs for weight management"). 26 May 2026. globalnews.ca
  26. Benefits and Pensions Monitor. Can benefit plans stomach the $77 million weight-loss drug bill? (Telus Health data: insurers paid nearly $77m for weight-management drugs in 2024; Ozempic counted as a diabetes drug; plan controls such as prior authorization, BMI thresholds and step therapy). benefitsandpensionsmonitor.com
  27. Gouvernement du Québec. Régime public d'assurance médicaments: who must be covered by a private group plan and who is covered by the public plan (about 46% of Quebecers). quebec.ca
  28. The dual role of GLP-1 receptor agonists in weight management and eating disorders: potential benefits and risks. J Psychiatr Res, 2026. DOI
  29. GLP-1 receptor agonist therapy and skeletal muscle: a narrative review with implications for older adults. JAR Life, 2026. DOI
  30. American Society of Anesthesiologists. New multi-society GLP-1 clinical practice guidance released. 29 October 2024. Declared interests: in the guidance paper, 2 of 10 authors declare consulting or speaking fees from Novo Nordisk (paper's own declaration). Link
  31. College of Physicians and Surgeons of Ontario. Virtual Care policy, updated June 2022 (physicians "must continue to meet the standard of care … including those pertaining to prescribing drugs"). Other provinces' colleges were not checked one by one. cpso.on.ca
  32. Health Canada. Unauthorized injectable peptide drugs seized and sold in Canada (advisory), 1 August 2025. recalls-rappels.canada.ca
  33. Brown J, Clarke C, Johnson Stoklossa C, Sievenpiper J. Canadian Adult Obesity Clinical Practice Guidelines: Medical Nutrition Therapy in Obesity Management. Obesity Canada, Version 2, 21 October 2022 (recommendation 2: individualized medical nutrition therapy from a registered dietitian). obesitycanada.ca (PDF)

Last checked 12 Oct 2026 · Next review due Jan 2027 · Report an error

How this guide was made. Written by the GLP Guidebook team from the sources above: Canadian product monographs and international labels, the Canadian obesity and diabetes guidelines, Canada's Drug Agency, provincial drug plans and published trials. It's general information, not medical advice. Talk to your family doctor, nurse practitioner or pharmacist before starting, stopping or changing any medicine. In an emergency, call 911. For health advice that isn't an emergency, call 811 in most provinces and territories (Info-Santé 811 in Quebec). How we write