Am I Eligible for Weight-Loss Injections? (BMI & Criteria for SA)

Eligibility comes down to your BMI, your health, and a clinician's judgement. Here are the thresholds commonly used in South Africa — and the situations where these medicines aren't appropriate.

The thresholds commonly used

Clinicians generally consider weight-loss medication for adults with:

A BMI of 30 or more (obesity), or
A BMI of 27 or more with a weight-related health condition — for example type 2 diabetes, high blood pressure, high cholesterol, sleep apnoea or fatty liver.

These mirror the criteria used in the trials and by regulators. They're a starting point for a conversation, not an automatic yes.

Health factors a provider will weigh

Your medical history and current medicines (e.g. insulin, which raises hypo risk).
History of pancreatitis or gallbladder disease.
Personal/family history of medullary thyroid carcinoma or MEN 2.
Whether you're pregnant, planning pregnancy or breastfeeding.
Your previous attempts, goals and ability to sustain treatment.

When these medicines aren't appropriate

They're generally not recommended in pregnancy, for people in the healthy or underweight BMI range, or where specific contraindications apply. They're also not a quick aesthetic fix — they're medical treatment for a medical condition.

Note

If your BMI is in the healthy range, weight-loss medication is usually not indicated. A provider can discuss safer goals.

Check your BMI

BMI is one input, not the whole picture (it doesn't distinguish muscle from fat), but it's the usual starting number. Use our private BMI calculator — nothing you enter leaves your device.

Your next step

If you think you might meet the criteria, the right next step is a proper assessment. A registered provider can confirm eligibility, check for contraindications, and — if appropriate — start you safely.

Check your eligibility with a registered provider

Frequently asked questions

What BMI do you need for weight-loss injections?

Commonly a BMI of 30+, or 27+ with a weight-related condition such as type 2 diabetes or high blood pressure. A clinician makes the final call.

Can I get them if my BMI is under 27?

Usually not — below the thresholds these medicines aren't generally indicated for weight loss. A provider can advise on alternatives.

Do I need diabetes to qualify?

No. Obesity (BMI 30+) on its own can meet the threshold; diabetes is one of the conditions that lowers the threshold to BMI 27+.

Sources & references

We cite primary sources and paraphrase them. Last reviewed June 2026. See our editorial policy and full sources hub.

1STEP programme — semaglutide for weight management — New England Journal of Medicine (Wilding et al., STEP 1, 2021). Average weight loss with semaglutide 2.4 mg (~15% at 68 weeks).

2SURMOUNT-1 — tirzepatide for weight management — New England Journal of Medicine (Jastreboff et al., 2022). Average weight loss with tirzepatide (up to ~21–22.5% at highest dose).

3Manufacturer Patient Information Leaflets (Novo Nordisk / Eli Lilly) — Novo Nordisk; Eli Lilly. Approved dosing, administration and side-effect information.

4SAHPRA — registered health products & safety alerts — South African Health Products Regulatory Authority. SA registration status of medicines and counterfeit / falsified-product warnings.

Am I eligible for weight-loss injections?