A clear walk-through of the questions, health history and safety checks a registered doctor uses to decide whether GLP-1 treatment is right for you.
Why the first consultation matters
The first appointment is where a doctor works out whether this class of treatment fits your body, your health history and your goals. It is not a form to rush through. GLP-1 medication needs a doctor's oversight in South Africa, so a HPCSA-registered doctor has to assess you properly before treatment begins.
Expect a conversation more than a lecture. The doctor is building a picture of your health so the plan is safe and realistic for you.
What the doctor will ask
Most of the consultation is history taking. The questions may feel personal, but each one has a reason behind it.
Your weight and health goals
The doctor will ask what you want to change and why now. Weight that affects your knees, your sleep, your energy or your blood sugar all point in slightly different directions, so being honest here helps.
Your medical history
You will be asked about current and past conditions, especially blood pressure, cholesterol, type 2 diabetes, thyroid problems and any digestive issues. This tells the doctor whether treatment could help a weight-related condition, and whether anything makes it unsafe.
Medicines and past attempts
Bring a list of everything you take, including over-the-counter products and supplements. The doctor also wants to know what you have tried before, from eating plans to other treatments, and how your body responded.
Family history
Some questions cover your family, not just you. A family history of certain thyroid cancers or a rare hormone condition changes the answer, which is why it comes up early.
The safety checks
Alongside the history, the doctor confirms there are no reasons you should not use this treatment. This class of medication is not appropriate during pregnancy or breastfeeding, or for anyone with a personal or family history of medullary thyroid cancer or MEN 2.
The doctor may measure your height, weight and blood pressure, and might request blood tests. These help confirm the full picture rather than relying on numbers alone.
How eligibility is decided
South African and international guidance uses body mass index (BMI) as a starting point, read together with the rest of your health.
- A BMI of 30 or above is one common threshold.
- A BMI of 27 or above may qualify when there is a weight-related condition such as type 2 diabetes, high blood pressure, high cholesterol, sleep apnoea or fatty liver.
- The doctor weighs the likely benefit against any risks specific to you.
BMI is a guide, not the whole story. Two people with the same number can get very different advice, because the decision rests on the full history, not one figure.
Talking through how it works
If treatment looks suitable, the doctor will explain the mechanism in plain terms. These medicines act like a gut hormone that influences appetite and helps quiet the constant "food noise" that makes eating hard to manage. Some are a weekly injection, others a daily one.
You should also hear an honest account of what to expect. Results vary from person to person. Trial averages range from roughly 8% to over 20% of body weight depending on the medicine and the dose, and medication works best alongside changes to how you eat and move. Side effects, cost in Rand and what your medical aid may or may not cover are all fair to raise here.
Deciding together
By the end, you and the doctor should agree on one of a few outcomes: start treatment, run further tests first, or focus on another approach because this one is not the right fit. If treatment begins, you will usually start on a low dose and build up slowly, with follow-up appointments to check how you are doing.
There is no pressure to decide on the spot. A good consultation leaves you understanding the plan, not just agreeing to it.
This is general information and not medical advice. Only a registered doctor can review your history and decide what suits you as an individual.
If your BMI is 30 or above, or 27 or above with a weight-related condition, it may be worth booking a consultation to talk it through with a doctor.
The short version
- The first appointment is mostly history taking, so be ready to talk about your health, medicines and family background.
- The doctor checks for reasons treatment would be unsafe, including pregnancy, breastfeeding and certain thyroid and hormone conditions.
- Eligibility usually starts at a BMI of 30, or 27 with a weight-related condition, but the full picture decides.
- You leave with a shared plan, whether that is starting treatment, doing more tests, or trying another route.
See if this could be an option for you
A two-minute eligibility check, reviewed by a doctor registered with the HPCSA. No obligation, and you only pay if treatment is right for you.
Check if I qualifyWondering if this applies to you?
The eligibility check is free and takes about two minutes.
This article is general information, not medical advice, and it cannot take the place of a consultation. GLP-1 medicines require assessment by a doctor registered with the HPCSA. Speak to a doctor about your own circumstances. See our medical disclaimer and editorial policy.