Thinking About a GLP-1 but Something Is Holding You Back?
A Medical Perspective on Who Actually Shouldn’t Try One
If you’ve been considering a GLP-1 medication but feel stuck in the “almost” phase, you’re not alone. I talk to patients every week who say things like:
“I think it could help me, but I’m nervous.”
“I’m worried I’m not a good candidate.”
“I don’t know if there’s a medical reason I shouldn’t try it.”
Those are valid concerns. And the good news is this: from a medical standpoint, the list of people who truly cannot try a GLP-1 is much smaller than most people think.
Let’s walk through this clearly, calmly, and without fear-based messaging.
First, a Reframe: Caution Is Not the Same as Ineligibility
GLP-1 receptor agonists have been studied for years, first in diabetes and now extensively in weight and metabolic health. For most adults who meet eligibility criteria, these medications are considered safe when prescribed appropriately and monitored.
What often holds people back is not a true medical barrier, but uncertainty, misinformation, or stories pulled out of context on social media.
So let’s separate medical contraindications from manageable concerns.
The Very Small List of True Medical Reasons You Should Not Try a GLP-1
From a medical perspective, there are only a few clear situations where GLP-1 therapy is not recommended.
1. Personal or Family History of Medullary Thyroid Cancer
This includes MEN2 (Multiple Endocrine Neoplasia type 2).
This is a hard stop. It is rare, but it matters. This warning comes from animal studies and remains a strict contraindication in humans. However, thyroid issues in general or thyroid nodules are not included on the list of reasons you can not try a GLP1.
If this applies to you, GLP-1s are not the right tool, and other options should be explored.
2. Prior Severe Allergic Reaction to a GLP-1 Medication
This is uncommon, but if someone has experienced a true anaphylactic reaction to one of these medications, they should not be re-challenged.
3. Active or Severe Gastroparesis
GLP-1s slow gastric emptying. For most people, this is part of how they help with appetite regulation.
For someone with severe or symptomatic gastroparesis, this can worsen symptoms significantly. Mild GI symptoms or a sensitive stomach does not automatically mean gastroparesis.
This is a situation where a careful provider evaluation matters.
4. Pregnancy or Actively Trying to Conceive
GLP-1s are not recommended during pregnancy or while trying to become pregnant.
This is not about long-term fertility damage. It is about safety during pregnancy itself.
That’s the list.
Yes, really.
What Is Often Mistaken as a Medical Disqualification (But Usually Isn’t)
This is where a lot of hesitation comes from.
“I Have GI Issues”
Most GI side effects are dose-related and temporary. They are not automatic disqualifiers. Low-and-slow dosing and proper support make a huge difference.
“I’m Afraid of Side Effects”
Side effects are possible with any medication. What matters is understanding:
What’s common
What’s temporary
What’s manageable
When to adjust dose or pause
Fear without context often feels bigger than the actual risk.
“I Don’t Have a Lot of Weight to Lose”
GLP-1s are not just weight medications. They impact insulin resistance, inflammation, cardiometabolic risk, and appetite signaling.
This is where individualized care matters more than a number on the scale.
“I’ve Failed Before”
GLP-1s are not a test of willpower. They work on physiology, not motivation.
A past struggle does not predict future failure.
What Being “Ready” Actually Means Medically
From a clinical standpoint, readiness is not about perfection. It’s about:
Understanding this is a tool
Being open to monitoring and follow-up
Willingness to start low and adjust slowly
Having realistic expectations
You do not need to have everything figured out before you start. You just need appropriate guidance.
A Final Thought From a Medical Perspective
If something is holding you back, it’s worth asking this question:
Is this a true medical contraindication, or is it uncertainty that could be clarified with the right information?
Most people who hesitate are not unsafe candidates. They’re cautious candidates. And caution is not a weakness. It’s an opportunity for education.
If you’re still in the thinking phase, that’s okay. Informed decisions are better decisions.
And sometimes, understanding that the medical “no” list is very short is the reassurance people need to take the next step.
Educational content only. Not medical advice. Always consult a licensed healthcare provider to determine what is appropriate for you.