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The Blue Cross Blue Shield Federal Employee Program criteria for Saxenda and Wegovy, policy 5.99.030, effective July 1, 2026, require prior participation in a comprehensive weight management program, and at renewal that an adult has lost at least 5 percent of baseline body weight OR the patient has continued to maintain their initial 5 percent weight loss. That is one of the few places in these documents where maintaining rather than losing is written down as a reason to keep paying

Further, if documentation states uncontrolled, did the clinician specify hyperglycemia or hypoglycemia

According to the FDA, Wegovy is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater

Daily injections can feel burdensome, especially when results are modest