10 Questions Your GLP-1 Doctor Should Ask You (and Red Flags If They Don't)

Not all GLP-1 prescribers are created equal. Some providers conduct thorough clinical evaluations before writing a prescription. Others move patients through a high-volume funnel that prioritizes speed over safety. The difference is easy to spot — if you know what to look for.

Here are the ten questions every GLP-1 provider should ask before prescribing medication. If your doctor or telehealth provider skips more than one or two of these, it's worth reconsidering whether they're the right provider for your care.

1. "Do You or Any Family Members Have a History of Thyroid Cancer?"

Why it matters: Both semaglutide and tirzepatide carry a boxed warning — the FDA's most serious safety communication — regarding medullary thyroid carcinoma. A personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) is an absolute contraindication. Skipping this question isn't just careless; it's clinically negligent.

Red flag if skipped: 🔴 Critical. This is the single most important screening question for GLP-1 therapy.

2. "Have You Ever Had Pancreatitis?"

Why it matters: GLP-1 receptor agonists have been associated with cases of acute pancreatitis. While the absolute risk is low, patients with a history of pancreatitis face a higher baseline risk. Your provider needs to weigh benefits against this elevated risk and monitor accordingly.

Red flag if skipped: 🔴 Critical. Not a contraindication, but requires informed clinical judgment.

3. "What Medications Are You Currently Taking?"

Why it matters: GLP-1 medications interact with insulin, sulfonylureas (risk of hypoglycemia), oral contraceptives (reduced absorption due to delayed gastric emptying), warfarin, and levothyroxine. Your provider needs the full picture — including over-the-counter supplements — before prescribing.

Red flag if skipped: 🔴 Critical. Drug interactions with GLP-1s can cause serious harm, particularly hypoglycemia in diabetic patients on insulin.

4. "Have You Had Any Kidney or Liver Problems?"

Why it matters: GLP-1 side effects (nausea, vomiting, diarrhea) can cause dehydration that worsens existing kidney disease. Liver enzymes should be at baseline before starting treatment. Your provider should order or review recent metabolic labs.

Red flag if skipped: 🟡 Important. May not affect eligibility, but affects monitoring requirements.

5. "What's Your History With Weight Loss Attempts?"

Why it matters: This isn't gatekeeping — it's clinical context. A history of diet attempts, prior weight loss medications, and weight cycling helps the provider understand your metabolic pattern and set realistic expectations. It also helps determine the right starting approach for you.

Red flag if skipped: 🟡 Important. A provider prescribing without understanding your weight history is operating with incomplete information.

6. "Are You Pregnant, Breastfeeding, or Planning to Become Pregnant?"

Why it matters: GLP-1 medications are contraindicated during pregnancy and breastfeeding. Semaglutide should be stopped at least 2 months before conception; tirzepatide at least 1 month. Additionally, GLP-1s can increase fertility by normalizing ovulation — so unplanned pregnancy is a real risk if contraception isn't discussed.

Red flag if skipped: 🔴 Critical (for patients of childbearing age). Legal and ethical obligation.

7. "Do You Have Any History of Eating Disorders?"

Why it matters: GLP-1 medications profoundly suppress appetite. For patients with a history of restrictive eating disorders (anorexia nervosa, ARFID), this effect could be dangerous rather than therapeutic. For patients with binge eating disorder, GLP-1s may actually be beneficial — but the distinction requires clinical nuance, not a checkbox.

Red flag if skipped: 🟠 Significant. Increasingly recognized as essential screening for GLP-1 therapy.

8. "How Is Your Mental Health? Any History of Depression or Suicidal Thoughts?"

Why it matters: The FDA is evaluating post-market reports of suicidal ideation in GLP-1 users. While large studies haven't found a causal relationship, responsible prescribers establish a mental health baseline and monitor for changes — especially during the first three months of treatment.

Red flag if skipped: 🟠 Significant. Growing clinical consensus that mental health screening should be standard.

9. "Do You Have Gallbladder Issues or a History of Gallstones?"

Why it matters: Rapid weight loss increases gallstone risk. GLP-1 therapy produces rapid weight loss. If you already have gallbladder disease or a history of gallstones, your provider needs to monitor for biliary symptoms and educate you on what to watch for.

Red flag if skipped: 🟡 Important. Not a deal-breaker, but affects patient education and monitoring.

10. "What Are Your Goals, and What Does Your Follow-Up Plan Look Like?"

Why it matters: GLP-1 therapy isn't "take this pill and check back in a year." Effective treatment requires dose titration over weeks to months, monitoring for side effects, periodic lab work, and regular assessment of progress. A provider who doesn't discuss follow-up isn't planning to manage your treatment — they're planning to fill a prescription.

Red flag if skipped: 🔴 Critical. The absence of a follow-up plan is the clearest sign of a prescription mill.

What This Looks Like in Practice

A quality consultation — whether in-person or via telehealth — should feel like a conversation, not a transaction. The provider should demonstrate genuine interest in your health profile, explain their clinical reasoning, and make you feel comfortable asking questions.

If your experience feels more like an assembly line — minimal questions, rapid approval, payment page — pause and consider whether this is the standard of care you want for a medication you'll be taking for months or years.

A responsible provider would rather lose a patient by being thorough than gain one by cutting corners.