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Reading path6 guides, in order

I'm thinking about a GLP-1 for my weight. Where do I start?

A reading path for anyone in Canada weighing up Wegovy or Zepbound, in the order that makes the decision easier.

GLP Guidebook teamUpdated 12 Oct 20265 min read13 sourcesWritten from published sources
The short answer

Start with your health, not the medicine. The Canadian obesity guideline uses BMI and waist size to judge risk, with a lower BMI line for South, Southeast and East Asian adults. Medicines are one option, alongside food, activity and sometimes surgery. No provincial plan covers them for weight management, so most people use private insurance or pay themselves. GLP-1s are usually long-term and have side effects. These six guides walk you through the decision in order.

Read this page first. It covers what the BMI and waist thresholds mean for you, who pays, how to make the decision and what to expect if you start. At the end, six guides take you further, in order.
On this page
  1. BMI and waist thresholds
  2. Who pays
  3. The decision, step by step
  4. What to expect
  5. The risks, in brief
  6. What to read next
  7. Sources

What do the BMI and waist thresholds mean for me?

They measure health risk. They don't decide whether you should take a medicine.

BMI (body mass index) compares your weight with your height. Waist size shows how much fat sits around your belly.

The Canadian Adult Obesity Clinical Practice Guideline uses lower numbers for adults of South, Southeast or East Asian background.1

MeasureMost adultsSouth, Southeast or East Asian
Overweight (BMI)25 to 29.91From 231
Obesity (BMI)30 or more130 or more ("severe risk")1
Waist, higher riskMen 102 cm (40 in), women 88 cm (35 in)1Men 85 cm (33.5 in), women 75 cm (29.5 in)1

Where medicines come in. Wegovy and Zepbound are approved by Health Canada for adults with a BMI of 30 or more, or 27 to under 30 with at least one weight-related health problem, such as high blood pressure.2,3 The Canadian guideline uses the same numbers, and asks doctors to use ethnicity-specific BMI and waist measures as well.5 Ozempic and Mounjaro are approved only for type 2 diabetes; using them for weight is off-label.5

A number is not a prescription. Being over a threshold means a prescriber may consider a medicine. It doesn't mean you qualify. It's a starting point for a conversation with your family doctor or nurse practitioner.

Who pays?

For weight management, usually private insurance or you. Checked 12 Oct 2026.

  • Provincial plans. None covers Wegovy, Zepbound or Saxenda for weight management. Public price talks for Wegovy ended without agreement in December 2025.10
  • Private insurance. Only a small number of private insurers cover these medicines for weight, usually with a prior authorization form, BMI rules or step therapy.11
  • Paying yourself. Prices and a year's cost are in Guide 6.

If you also have type 2 diabetes, provincial plans cover semaglutide for diabetes with conditions; see the type 2 diabetes path.

How should I make the decision?

One step at a time, in this order. Each step has a guide.

1Check your numbers and health (Guide 1)
2Compare all your options (Guide 3)
3Ask if a GLP-1 fits you, and when not (Guide 4)
4Weigh the side effects (Guide 5)
5Talk to your family doctor; check coverage and prices (Guide 6)
6Using a virtual clinic or program? Check it first (Guide 7)
7Review how it's going with your prescriber

Medicines don't replace food and activity changes. The WHO says GLP-1 treatment should come with support for healthy eating and physical activity, and the Canadian guideline pairs every medicine with health behaviour changes.4,5

Step 6 matters if you go online. A doctor seeing you virtually must meet the same standard of care as in person, including when prescribing.12 Health Canada says to buy prescription drugs only from a licensed pharmacy, and to check the DIN on the label.13

The review step matters too. Regulators have traditionally advised stopping if 5% of your weight hasn't gone after 3 months on a full dose; the Canadian guideline adds that health gains can matter whatever the amount lost.5 For someone who started at 90 kg (198 lb), 5% is 4.5 kg (about 10 lb).

What should I expect if I do start?

Expect three things:

  • weight loss that is real, but varies a lot from person to person
  • stomach side effects for many people, especially early on
  • a long-term commitment, because the weight tends to return after stopping

The main semaglutide weight trial, STEP 1, shows what to expect. People were put into two groups at random. One group got the medicine and the other a dummy injection with no medicine in it. Both groups got the same diet and activity advice. So the gap between the two groups is what the medicine added.6

Average share of body weight lost, and what that means for someone who starts at 90 kg (198 lb):

STEP 1Semaglutide 2.4 mg (Wegovy), weekly

1,961 adults with obesity or overweight and no diabetes, 68 weeks.6

Semaglutide14.9%about 13 kg
Dummy injection2.4%about 2 kg

So about 12.5% of body weight, or 11 kg (25 lb) for a 90 kg person, came from the medicine itself.

These are averages, and people varied a lot. On semaglutide, about 86 in 100 lost at least 5% of their body weight, against about 32 in 100 on the dummy injection, and about 1 in 3 lost 20% or more. Put the other way, about 1 in 7 on semaglutide lost less than 5%.6

Most of the weight usually comes back after stopping. A year after stopping, people followed up from STEP 1 had regained about two-thirds of what they lost.7 So plan as if you'll stay on it, and budget for years, not months. Guide 9 covers stopping.

Just a few kilos?It's for a family memberBMI calculator

What to read next, in order

These six guides go deeper. Each one ends with a link to the next, so you can read them one after another.

  1. 1Weight and health: what BMI and waist numbers meanGuide 1 of 9UnderstandCheck where you stand with BMI and waist size, including the lower numbers for Asian adults.
  2. 2Your options, and where medicines fitGuide 3 of 9DecideSee lifestyle support, other medicines, GLP-1s and surgery side by side before you pick one.
  3. 3Should I consider a GLP-1? And when not toGuide 4 of 9DecideWho prescribers may consider for a GLP-1, who pays, and the times it isn't a good idea.
  4. 4Side effects and risksGuide 5 of 9DecideWhat the first weeks feel like, and the rarer risks to know before you start.
  5. 5Getting a prescription in CanadaGuide 6 of 9Do it safelyWho may prescribe, who pays, the approved brands and generics, recalls, fakes and official prices.
  6. 6Choosing a doctor, clinic or programGuide 7 of 9Do it safelyFamily doctor, virtual clinic or pharmacy program: what each offers, how they charge and what to check.
Was this page easy to understand?

Sources

  1. 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 classes; Table 2 and text, waist cut-offs). obesitycanada.ca (PDF)
  2. Novo Nordisk Canada. Wegovy (semaglutide injection) Product Monograph, revised 2 October 2026 (indications). PDF
  3. Eli Lilly Canada. Zepbound (tirzepatide injection) Product Monograph, 11 June 2026 (indications). PDF
  4. World Health Organization. WHO issues global guideline on the use of GLP-1 medicines in treating obesity. 1 December 2025. Link
  5. 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; contraindications; pregnancy and contraception; off-label use; traditional 5% check). obesitycanada.ca (PDF)
  6. Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). NEJM, 2021;384:989–1002. 1,961 adults without diabetes, 68 weeks. DOI
  7. Wilding JPH et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022;24(8):1553–1564. 327 people followed for a year after stopping. DOI
  8. Novo Nordisk. Wegovy (semaglutide) US prescribing information, revised June 2026. Sections 1, 2.2, 5.2, 5.3, 5.5, 8.3, 17. (US label.) PDF
  9. Novo Nordisk. Ozempic (semaglutide) injection, US prescribing information and Medication Guide, revised May 2026. Sections 4, 5.3, 5.5, 5.6, 7.2, 8.5. (US label.) PDF
  10. BC PharmaCare. Drug coverage decision: semaglutide (Wegovy), 18 December 2025 ("Non-benefit"; pCPA negotiations concluded without agreement on 1 December 2025). Status of public plans checked 12 October 2026. gov.bc.ca (PDF)
  11. 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; Benefits and Pensions Monitor on plan controls. globalnews.ca · benefitsandpensionsmonitor.com
  12. College of Physicians and Surgeons of Ontario. Virtual Care policy, updated June 2022. cpso.on.ca
  13. 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

Last checked 12 Oct 2026 · Next review due Jan 2027

How this page was made. Written by the GLP Guidebook team from the sources above: Canadian and US drug labels, published trials, the Canadian obesity guideline, WHO guidance and official Canadian pages. 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. How we write