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01 — 12
What is your biological sex?
Certain medications have sex-specific safety profiles that help us refine your results.
02 — 12
Are you currently pregnant, breastfeeding, or planning to conceive?
Weight loss medications are not indicated during pregnancy or breastfeeding. Your safety always comes first.
06 — 12
What is your height and weight?
We'll calculate your BMI instantly. A BMI of 30+ qualifies for anti-obesity medication. BMI 27+ may also qualify if a weight-related health condition is present — we'll screen for that next.
Feet
Inches
Weight — lbs
Your BMI
—
—
Under
Normal
Over
27
30
35+
03 — 12
Do you experience any of the following?
These conditions are common alongside weight challenges and help us understand the full picture. We offer support for all of them. Select all that apply.
Emotional eating — eating in response to stress, boredom, or emotions
Anxiety — persistent worry, nervousness, or panic
Depression — persistent low mood, loss of interest, or hopelessness
OCD — obsessive thoughts or compulsive behaviours
Binge eating — recurring episodes of eating large amounts rapidly
Trauma or PTSD — past traumatic experiences affecting daily life
None of the above apply to me
04 — 12
How would you describe your current physical activity level?
Your activity level helps us understand your starting point and tailor our recommendations for you.
05 — 12
How would you describe your current eating habits?
No wrong answers — this helps us understand where you are so we can offer the right support.
03 — 12
Do you have any of these weight-related conditions?
With a BMI between 27 and 29.9, you may still qualify for anti-obesity medication if you have at least one of the following conditions. Select all that apply.
High blood pressure (hypertension)
Obstructive sleep apnea (OSA)
Type 2 diabetes
Dyslipidemia (high cholesterol or triglycerides)
Non-alcoholic fatty liver disease (NAFLD)
Osteoarthritis or joint pain related to weight
Cardiovascular disease (heart disease or stroke history)
Polycystic ovary syndrome (PCOS)
None of the above apply to me
07 — 12
Do you have any of these conditions?
Select all that apply — this helps identify which medications are safe for your body.
Personal or family history of medullary thyroid carcinoma (MTC)
Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
History of pancreatitis — acute or chronic
Seizure disorder or epilepsy
Current or past eating disorder — anorexia or bulimia nervosa
Severe liver disease
Severe kidney disease or end-stage renal disease
Gallbladder disease or history of gallstones
None of the above apply to me
08 — 12
Are you currently taking any of these medications?
Some medications interact with weight loss treatments. Select all that apply.
Opioids or opioid-containing medications — codeine, morphine, oxycodone, etc.
MAO inhibitors (MAOIs)
Insulin or insulin secretagogues — e.g. sulfonylureas
Another GLP-1 receptor agonist — liraglutide, dulaglutide, exenatide
Warfarin or other blood thinners
None of the above apply to me
09 — 12
Any history of the following?
Select all that apply — this helps your physician ensure the safest approach for you.
Bipolar disorder or mania
Severe depression or suicidality
Alcohol or substance dependence
Uncontrolled high blood pressure
Type 1 diabetes
Gastroparesis — slow stomach emptying
None of the above apply to me
10 — 12
Any known allergies to these ingredients?
Select all that apply.
Naltrexone or bupropion — active ingredients in Contrave
Semaglutide or tirzepatide — active ingredients in Wegovy, Ozempic, Mounjaro, Zepbound
No known allergies to these ingredients
11 — 12
Do you have a family doctor or primary care provider?
Your answer helps us guide you to the most direct path forward after your results.
