Clinician answer
Under the FDA label, no — Zepbound is approved for BMI ≥30 or ≥27 with a weight-related comorbidity, and cash-pay telehealth providers largely follow the same threshold to stay on-label. Off-label prescribing exists but is uncommon at BMI 25 and increases legal + insurance exposure for the prescriber. The realistic paths at BMI 25 are: address a specific comorbidity (sleep apnea, PCOS, MASH) if present, or focus on structured lifestyle programs — a GLP-1 at that starting weight is a high-risk-low-reward choice.
Answered by Dr. Jane Novak, MD, MPH