What Medical History to Tell Your GLP-1 Provider

What Medical History Should You Tell Your GLP-1 Provider First?

Here is the short version. The full matrix is next.

• Family or personal history of medullary thyroid cancer or MEN 2 — the single hardest stop on a weight-management GLP-1 prescription. Tell them.
• Pregnancy, planning a pregnancy, or breastfeeding — these change whether and when therapy makes sense, and the rules differ by drug.
• Pancreatitis, gallbladder disease, severe gastroparesis, kidney disease, liver disease, or diabetic retinopathy — most of these aren't automatic disqualifiers, but each one changes the drug, the dose, or the monitoring plan. Severe gastroparesis is "not recommended" on multiple labels.
• Type 1 or type 2 diabetes, and any insulin or sulfonylurea — your provider needs to adjust those proactively to prevent low blood sugar.
• Every prescription, OTC product, vitamin, and supplement — bring a photo of every label if you're not sure of doses.
• Oral birth control — especially important with tirzepatide (Zepbound, Mounjaro) and orforglipron (Foundayo).
• Eating disorder history, past or present — this isn't about being judged. It's about being kept safe.
• Any surgery, endoscopy, colonoscopy, or dental work with sedation — anesthesia teams need to know, no matter how minor the procedure feels.
• Any GLP-1 you've already used — brand, compounded, or "research peptide." Include the dose and your last dose date.

If you read that list and you're feeling like, "wait, I'm not sure that thing matters" — disclose it anyway. The wrong move is hiding something because you're afraid of being denied. Many of these disclosures don't stop a prescription. They change which drug, which dose, and what gets watched.

Contraindication, Warning, or "We Don't Know" — How to Read the Matrix

• Contraindication — the FDA label says the drug generally should not be used in this situation. Medullary thyroid cancer history is a contraindication. A prior serious allergic reaction to the same drug is a contraindication.
• Warning or precaution — the label flags a risk that requires careful evaluation, closer monitoring, or counseling. Pancreatitis history is a warning, not a contraindication. Gallbladder disease is a warning. Kidney disease is a warning.
• Not recommended — the label tells prescribers to avoid the drug in this situation even though it isn't a formal contraindication. Severe gastroparesis falls here. Combining two GLP-1s falls here.
• Unknown or not studied — the label says safety data are limited in this group, so caution applies.

Your job is to disclose. Your provider's job is to sort. Don't try to do their job by hiding what you think might disqualify you.

The GLP-1 Provider Disclosure Matrix

Built from every current FDA prescribing label for weight-management and diabetes GLP-1 drugs (Wegovy, Zepbound, Foundayo, Saxenda, Ozempic, Mounjaro) on DailyMed, stacked against the October 2024 anesthesia guidance, the January 2026 FDA suicidal-ideation label change, the 2026 FDA actions on compounded GLP-1s, and common insurance documentation requirements. Last verified May 11, 2026.

Who Should Not Take a GLP-1? The Absolute Contraindications

Family or personal history of medullary thyroid cancer (MTC)

This sits at the top of every weight-management GLP-1 label in a black box — the FDA's strongest warning level. In rat studies, GLP-1 drugs caused thyroid C-cell tumors. Whether the same happens in people isn't known. The FDA's position is "we don't take the chance."

What counts: any family history of medullary thyroid cancer, plus your own personal history. The labels don't limit family history to first-degree relatives. What doesn't count the same way: papillary thyroid cancer, follicular thyroid cancer, Hürthle cell, or anaplastic thyroid cancer. Those are different diseases and are not contraindications.

What to say: "My [relative] had thyroid cancer. I don't know the type. Can we figure out whether it was medullary before deciding?"

Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

MEN 2 is an inherited condition that raises the risk of medullary thyroid cancer and a few other endocrine tumors. It's rare. It runs in families. People who carry the RET gene mutation often know, because genetic testing is common when one relative is diagnosed. If you've ever had genetic testing positive for MEN 2 — even without active disease — that disclosure sits in the same bucket as MTC.

Prior serious allergic reaction to a GLP-1

A serious allergic reaction means anaphylaxis (the kind that needs an EpiPen or an ER) or angioedema (severe swelling of the face, lips, or throat). A mild rash isn't this. Same-drug rule: don't go back to the drug that caused the reaction. Class rule: be cautious about the whole GLP-1 class, but it isn't an automatic ban — your provider decides based on what reaction you had and to which ingredient.

Currently pregnant

Weight loss isn't appropriate during pregnancy. Every weight-management GLP-1 label says to discontinue the medication when pregnancy is recognized. If you're already on a GLP-1 and you find out you're pregnant: contact your prescriber the same day. Don't take another dose until they review it. For pregnancy planning and breastfeeding, the rules differ by drug. See the pregnancy section below.

Currently on another GLP-1 — not a formal contraindication, but don't stack

The labels for Wegovy, Zepbound, Mounjaro, and Foundayo all say not to combine GLP-1 medications or semaglutide-containing products. This isn't a formal contraindication on the label, but the instruction is clear: switch, don't stack. If you're transitioning from one GLP-1 to another, your prescriber will plan the switch.

Conditions That Don't Stop the Prescription — But Change the Plan

Pancreatitis history

The FDA labels for GLP-1s include pancreatitis as a warning. They also note that GLP-1s have been associated with acute pancreatitis, though causality hasn't been established. Most providers will still prescribe after a single episode of pancreatitis with closer monitoring and patient education. Some will defer for a year. Disclose the year, the cause (gallstones, alcohol, triglycerides, autoimmune, idiopathic), and any hospitalizations or ERCP.

Gallbladder disease, gallstones, cholecystitis

Acute gallbladder disease is a labeled warning. GLP-1s can promote gallstone formation — one proposed mechanism is that GLP-1s reduce gallbladder motility. Rapid weight loss also raises gallstone risk independently. Disclose gallstones, cholecystitis, biliary pancreatitis, and gallbladder removal even if it was decades ago. Gallbladder removal doesn't disqualify you — it changes how seriously your provider will treat right-upper-belly symptoms later.

Severe gastroparesis or severe GI disease

GLP-1s slow gastric emptying as a mechanism. Severe pre-existing slowing is specifically called out on Wegovy, Zepbound, and Mounjaro labels as not recommended. This is a "not recommended" call, not an absolute contraindication, but most providers won't prescribe in this situation. Disclose diagnosed gastroparesis, bowel obstruction history, history of bowel resection, fundoplication, bariatric surgery, or inflammatory bowel disease.

Kidney disease and dehydration risk

Acute kidney injury has been reported with GLP-1 use, generally related to volume depletion from GI side effects — nausea and vomiting lead to less fluid intake. Existing kidney disease means less reserve when that happens. Disclose your CKD stage and most recent eGFR. Bring labs. If you've had an acute kidney injury or take diuretics, say so.

Diabetic retinopathy

Several GLP-1 labels include retinopathy monitoring language for patients with type 2 diabetes, based on the SUSTAIN-6 trial finding that rapid A1C improvement was associated with worsening retinopathy in a small percentage of patients early in treatment. This isn't a contraindication. It's a reason for baseline eye documentation and monitoring — particularly ophthalmology involvement if active retinopathy is present.

MASH, fatty liver with fibrosis, cirrhosis, or severe hepatic impairment

Wegovy now has an FDA-approved indication for adults with MASH and moderate-to-advanced fibrosis (not cirrhosis). Foundayo is not recommended in severe hepatic impairment. Disclose your fatty liver or MASH diagnosis, fibrosis stage if known, cirrhosis if present, most recent liver enzymes, and any FibroScan, biopsy, or hepatology notes. This affects both drug selection and indication.

Type 1 or type 2 diabetes

GLP-1s aren't FDA-approved for type 1 diabetes — some endocrinologists prescribe them off-label in carefully selected type 1 patients, but this is a specialist conversation. For type 2, the provider needs your current A1C, all glucose-lowering medications, any severe low blood sugar history, retinopathy status, and kidney labs. Your diabetes medications need a plan before the GLP-1 starts.

Eating disorder history — past or present

This is the disclosure people most often skip. GLP-1 medications suppress appetite. For someone with a history of restrictive eating, that mechanism is the same one that powered the eating disorder. For someone with bulimia, the slower stomach emptying can make purging behaviors worse. The National Eating Disorders Association and ANAD specifically flag this. A good provider screens. They may want a mental-health consultation before prescribing, suggest a different weight-management approach, or proceed with explicit monitoring and a safety plan.

What to say: "I have a history of [diagnosis]. I'm in [recovery / active / unsure status]. I want to know whether this medication is safe for me, or whether we should look at other paths."

Every Medication and Supplement You Should List (and Why Each One Matters)

Sources: Wegovy, Zepbound, Foundayo Prescribing Information, Drug Interactions sections, accessed May 11, 2026.

How to list medications correctly

When the intake form asks for medications, include: name, dose, frequency, prescriber, reason, and whether you're still taking it.

Format that works: "Levothyroxine 75 mcg, once daily in the morning, prescribed by Dr. Smith for hypothyroidism, current."

Things people commonly forget to list:

• Oral birth control (because it doesn't feel like a "medication")
• OTC sleep aids (Unisom, diphenhydramine, melatonin)
• Antacids and PPIs
• CBD or THC products
• "Pre-workout" or fat-burner supplements
• Herbal products (St. John's Wort interacts with many drugs)
• Antibiotics taken recently
• Anything you stopped in the last 30 days

Diabetes, Insulin, and Diabetic Eye Disease

What to bring if you have diabetes

• Most recent A1C, with the date
• Fasting glucose or CGM data (a screenshot or download works)
• Insulin type, basal dose, mealtime doses, correction scale
• Sulfonylurea name and dose
• Any low blood sugar episodes in the last 90 days
• Most recent eye exam date and any retinopathy diagnosis
• Most recent kidney labs

Why insulin and sulfonylureas need to be flagged

GLP-1 labels include hypoglycemia as a risk when combined with insulin or sulfonylureas. Insulin and sulfonylureas need a plan before the GLP-1 starts. Your prescriber decides the exact change. Going on a GLP-1 without that planning is one of the most common causes of preventable lows.

A note on type 1 diabetes

GLP-1s aren't FDA-approved for type 1 diabetes. Some endocrinologists prescribe them off-label in carefully selected type 1 patients. If you have type 1, this is a specialist conversation, not a telehealth intake form.

Pregnancy, Fertility, Breastfeeding, and Birth Control

Pregnancy and trying to conceive

If you're pregnant: every weight-management GLP-1 label says to discontinue when pregnancy is recognized. Contact your prescriber the same day. Don't take another dose until they review it. If you're trying to conceive: Wegovy's label says stop at least two months before a planned pregnancy because of how long semaglutide stays in your system. Tirzepatide and orforglipron have their own guidance.

Breastfeeding

Breastfeeding guidance is drug-specific. Foundayo is not recommended in nursing women. Wegovy tablets are not recommended during breastfeeding, while the Wegovy injection notes unknown human-milk transfer. Zepbound's April 2026 label now includes a small single-dose lactation study showing undetectable or low tirzepatide in breast milk, but with no data on infant effects or milk production. Tell your provider before starting or continuing while breastfeeding.

Oral birth control on tirzepatide (Zepbound, Mounjaro)

The labels for Zepbound and Mounjaro specifically tell women on oral birth control to switch to a non-oral method or add a barrier method (like condoms) for four weeks after starting the medication and after each dose increase. The reason is delayed gastric emptying — your stomach absorbs the pill more slowly, so blood levels may not reach the levels needed to prevent ovulation reliably.

Oral birth control on Foundayo (orforglipron)

Foundayo has a longer window. Backup contraception for 30 days after starting and 30 days after each dose increase. That's from the Medication Guide.

Non-oral methods that aren't affected

Hormonal IUD, copper IUD, implant, injection, patch, and ring don't go through the stomach, so they aren't affected by GLP-1 absorption changes. Same for tubal ligation and vasectomy.

What to say: "I take [brand] oral birth control. What do I need to do for backup during the first month?"

Stomach, Pancreas, Gallbladder, Kidney, and Liver History

Warning signs that don't wait

Once you've started a GLP-1, these symptoms need same-day attention:

• Severe upper-belly pain, especially radiating to the back (possible pancreatitis)
• Severe right-upper-belly pain with fever or yellow skin or eyes (possible gallbladder, possible cholangitis)
• Persistent vomiting with no urine output (possible AKI)
• Severe allergic reaction symptoms (swelling, trouble breathing)
• Vision changes

For non-severe symptoms — manageable nausea, mild constipation, occasional headaches — message your provider and follow the plan you were given. Don't increase the dose while symptoms are unresolved.

Surgery, Anesthesia, and Dental Sedation

What the current ASA guidance actually says

Before October 2024, the standard advice was to stop weekly GLP-1s for a week before surgery and daily GLP-1s for a day. That advice changed. The current multi-society guidance, published in October 2024, says most patients can continue their GLP-1 before elective surgery. The team manages risk through individualized planning — which can include a 24-hour liquid-only diet, anesthesia-plan changes, and point-of-care ultrasound of stomach contents in higher-risk patients. Higher risk means: you're in dose escalation, you're on a high dose, you have symptoms of delayed stomach emptying, or you have other conditions that affect gastric emptying.

When holding is still recommended

For some procedures and some patients, holding the drug is still the call. A 2025 AAOS-presented study in elective total hip and knee arthroplasty found lower anesthesia-related complication risk when semaglutide was stopped 14 days before surgery. That's procedure-specific evidence, not a universal rule. Endoscopy and dental sedation guidance is also procedure-specific. The right move isn't to apply a one-size rule yourself — it's to make sure every team knows.

What to tell the procedure team

Bring this information to every pre-op call and every check-in: drug name, dose, last dose date, whether you're in dose escalation, any GI symptoms in the last week, and diabetes status with glucose medications.

A short script: "I take [drug] at [dose]. My last dose was [date]. I want to make sure my anesthesia plan accounts for this."

Mental Health and Eating Disorder History

What's no longer a barrier

On January 13, 2026, the FDA issued a Drug Safety Communication stating that a comprehensive review of 91 clinical trials (107,910 participants) plus a separate Sentinel cohort of 2,243,138 users found no increased risk of suicidal ideation or behavior with GLP-1 receptor agonists. The agency requested manufacturers remove that warning from Saxenda, Wegovy, and Zepbound labels. Practical takeaway: a history of depression or anxiety is no longer the contraindication it was sometimes treated as. You should still tell your provider, because mental health affects appetite, eating patterns, medication adherence, and how you experience side effects. But you shouldn't avoid disclosure out of fear of being denied.

What still needs careful disclosure

Eating disorder history sits in a separate bucket and still needs careful disclosure. GLP-1 appetite effects can trigger relapse in restrictive presentations and complicate purging patterns. A good provider screens and may want a mental-health consultation, suggest a different approach, or proceed with explicit monitoring. Include all psychiatric medications — SSRIs, SNRIs, mood stabilizers, antipsychotics — in your medication list.

Weight History, Prior Attempts, and Insurance Documentation

What to bring on the clinical side

• Current weight and height (most providers calculate BMI; if BMI isn't right for your situation — athletes, body composition — say so)
• Weight history: highest adult weight, lowest adult weight, current
• Prior programs (Weight Watchers, Noom, Optavia, medically supervised)
• Prior weight-loss medications (phentermine, topiramate, naltrexone-bupropion, orlistat)
• Bariatric surgery, if applicable (type, date, results)
• Weight-related diagnoses: high blood pressure, dyslipidemia, type 2 diabetes or prediabetes, sleep apnea, fatty liver, PCOS, osteoarthritis

What insurance plans typically want

Insurance approval for GLP-1 weight management — when plans cover it at all — usually requires documentation of:

• BMI ≥ 30, or BMI ≥ 27 with a weight-related comorbidity
• The specific weight-related comorbidity diagnosis
• A documented attempt at lifestyle modification (often 3–6 months)
• A medical-necessity letter from the prescriber

If you're going through insurance, give your provider this information up front rather than waiting for them to ask. The medical-necessity letter is much easier to write when the documentation is already in hand.

Prior GLP-1 Use, Compounded Products, and "Research Peptides"

What to bring for prior brand GLP-1 use

• Drug name (Ozempic, Wegovy, Mounjaro, Zepbound, Rybelsus, Foundayo, Saxenda)
• Dose, in mg
• Start date and last dose date
• Side effects, even minor ones
• Reason for stopping (cost, supply, side effects, plateau, pregnancy, surgery)

Restarting at the same dose after a long gap is one of the most common causes of severe early side effects.

What to bring for compounded GLP-1 use

Compounded semaglutide and tirzepatide aren't FDA-approved as finished products. The FDA has issued specific alerts about dosing errors with compounded semaglutide, including cases requiring hospitalization. If you've been using a compounded GLP-1, bring:

• A photo of the vial label (concentration, lot number, pharmacy name)
• A photo of the dosing instructions you were given
• The dose in both mg and syringe units (for example, "0.5 mg = 25 units on a U-100 syringe")
• The pharmacy that compounded it
• The platform that prescribed it

"Research peptides"

Products sold online labeled "research peptide" or "not for human use" but used as injectable weight-loss drugs aren't legitimate medical products. They aren't FDA-approved and the FDA has warned that unapproved GLP-1 versions don't go through review for safety, effectiveness, or quality. If you've used one, disclose it. Your provider isn't going to lecture you. They're going to make sure they don't add a real prescription on top of something they can't verify.

The Pre-Appointment Disclosure Worksheet

Last updated: May 11, 2026. Copy or print it.

I Already Started and Forgot to Disclose Something — What Now?

When to Contact Your Provider Urgently

Symptoms that need same-day attention

• Severe abdominal pain, especially upper-belly pain that radiates to the back (pancreatitis)
• Right upper-belly pain with fever or yellow skin or eyes (gallbladder, possible cholangitis)
• Repeated vomiting that won't stop
• Severe diarrhea with signs of dehydration (dry mouth, low urine, dizziness)
• Allergic reaction symptoms: swelling of the face, lips, or throat, hives, trouble breathing
• New vision changes, especially if you have diabetic retinopathy
• Severe low blood sugar (shakiness, confusion, sweating, racing heart) — especially if you're on insulin or a sulfonylurea
• Fainting
• Positive pregnancy test
• Severe constipation with abdominal pain (possible bowel obstruction)

What not to decide on your own

• Don't increase your dose if you're having symptoms you can't manage
• Don't restart after a long gap (more than 2 weeks for weekly drugs) without checking in
• Don't combine GLP-1 medications
• Don't ignore pregnancy or surgery timing

What Changed in 2026 (And Why It Affects What You Disclose)

FDA requested removal of the suicidal ideation warning (January 13, 2026)

A comprehensive FDA review of 91 clinical trials (107,910 participants) plus a Sentinel cohort of 2,243,138 users found no increased risk of suicidal ideation or behavior with GLP-1 receptor agonists. The FDA requested manufacturers remove that warning from Saxenda, Wegovy, and Zepbound labels. Practical implication: mental health history is still worth disclosing, but it's no longer a contraindication to GLP-1 therapy.

Updated anesthesia guidance (October 2024)

The October 2024 multi-society guidance from the ASA and other professional societies replaced the prior blanket "stop GLP-1 before surgery" rule with an individualized, risk-based approach. Most patients can continue their GLP-1 before elective surgery. The anesthesia team now does individualized planning — which can include a 24-hour liquid diet, stomach ultrasound, and anesthesia adjustments for higher-risk patients. Your job remains the same: tell every team member you're on a GLP-1.

Compounded GLP-1 regulatory state (2026)

On April 30, 2026, the FDA proposed to exclude semaglutide, tirzepatide, and liraglutide from the 503B bulks list, which would end most compounded versions. As of May 2026, the FDA has documented 605 adverse-event reports involving compounded semaglutide and 545 involving compounded tirzepatide. If you've been using a compounded product, your disclosure to a new provider should include source pharmacy, concentration, and dosing method — not just the drug name.

How We Built This Page

Sources used (all verified May 11, 2026):

• Wegovy Prescribing Information, DailyMed (revised March 2026)
• Zepbound Prescribing Information, DailyMed (revised April 2026)
• Foundayo (orforglipron) Prescribing Information, DailyMed (revised April 2026)
• Saxenda Prescribing Information, DailyMed
• Ozempic Prescribing Information, DailyMed
• Mounjaro Prescribing Information, DailyMed
• FDA Drug Safety Communication: GLP-1 receptor agonists and suicidal ideation (January 13, 2026)
• FDA: Concerns with Unapproved GLP-1 Drugs Used for Weight Loss
• ASA Multi-Society Guidance on GLP-1 Medications and Perioperative Management (October 2024)
• FDA: Proposed exclusion of GLP-1s from 503B bulks list (April 30, 2026)

Frequently Asked Questions