The FAA has specific, medication-by-medication rules for weight loss drugs. Some GLP-1 medications are now CACI-eligible — meaning your AME may be able to issue on the spot. Others are flatly prohibited.
Informational Use Only. The information on this page reflects our understanding of current FAA medical certification requirements and is provided for general educational purposes only. FAA policies, the AME Guide, and CACI worksheets are updated frequently and without notice. The FAA AME Guide and FAA Civil Aerospace Medical Institute (CAMI) are the authoritative sources in all cases. Nothing on this page constitutes legal or medical advice. Always verify current requirements directly with your Aviation Medical Examiner and the official FAA AME Guide at faa.gov/ame_guide before making any certification decisions.
This Is Now a CACI Condition — With Important Limits
As of the updated FAA guidance (09/30/2026), weight loss management using a single approved medication is a CACI condition — your AME can issue your certificate on exam day without sending the case to the FAA, provided all criteria are met. However, the A1C gate is strict: if your A1C has ever been 6.5% or greater, you do not qualify for this CACI and must use the diabetes pathway instead. A one-week initial observation period applies to the listed diabetic medications used for weight loss, with 48 hours after each dose increase, medication change or formulation change. The current worksheet includes orforglipron (Foundayo) and oral or injectable semaglutide (Wegovy). Any diabetes history, including remission, excludes this pathway.
Your medication and A1C history determine which pathway applies.
Diet and exercise only — no medications
Orlistat (Alli/Xenical) — single agent, OTC
Single GLP-1 or metformin for weight loss (A1C ≤6.4%)
Combination of orlistat + one diabetic medication
Combination of two diabetic medications (e.g., metformin + GLP-1)
Any prohibited medication (phentermine, Contrave, Qsymia, etc.)
A1C ever ≥6.5%, or any diabetes history including remission
The FAA divides weight loss medications into three categories. The brand name matters — the same molecule approved for diabetes is treated differently than the weight-loss branded version.
Beyond the medication list, the FAA reviews your overall metabolic picture and any side effects that could affect flight safety.
Your A1C must be 6.4% or less at exam time, and you must have no history of ever testing at 6.5% or higher. A single prior A1C ≥6.5% removes you from the weight loss CACI permanently — you shift to the diabetes pathway.
Complete one week initially for the listed diabetic medications used for weight loss (including orforglipron and oral/injectable Wegovy), or 48 hours initially for orlistat. Observe 48 hours after each dose increase, medication change or formulation change under the applicable pathway, with no impairing side effects.
Nausea, vomiting, gastroparesis, or hypoglycemic symptoms that could interfere with flight duties are disqualifying — even from otherwise acceptable medications. Your treating physician must certify no such side effects are present.
A detailed Clinical Progress Note from a clinic visit within 90 days of your exam is required. It must confirm stability, current medications, and the absence of disqualifying symptoms or complications.
Any hypoglycemic event requiring intervention in the past 12 months is disqualifying for the weight loss CACI. This is especially relevant when GLP-1 drugs are used in combination with other diabetic agents.
Weight-related co-morbidities — sleep apnea, cardiovascular disease, hypertension — are evaluated separately and may have their own CACI or SI requirements that must also be satisfied.
Using the diabetes brand name (Ozempic, Mounjaro) instead of the weight loss brand (Wegovy, Zepbound) — the FAA distinguishes these
Any history of A1C ≥6.5% — disqualifies from the weight loss CACI entirely, regardless of current A1C
Incomplete 48-hour observation after a dose increase, medication change or formulation change
Not completing the one-week initial observation for a listed diabetic medication used for weight loss (or 48 hours for orlistat)
Undisclosed use of a prohibited medication (phentermine, Contrave, Qsymia)
Combination of two diabetic medications — not CACI eligible, requires Special Issuance
GI side effects (nausea, vomiting) not resolved — AME must defer if symptoms are present
Clinical note older than 90 days — the FAA requires it to be current
What sets our practice apart for weight management certification cases.
HIMS Senior AME
FAA-designated HIMS Senior AME with experience across the full spectrum of GLP-1 and weight management certification cases.
Pilot, Not Just a Physician
Active corporate jet pilot (ATP, CFI, CFII, MEI) — understands the real-world implications of medication timing and cockpit safety.
Direct Physician Access
You work directly with the doctor. No case managers, no handoffs — one point of contact from consultation through certification.
Remote Consultations
Pre-exam consultations available remotely so you know exactly what to bring and whether your current regimen is CACI-eligible before your exam day.
Modern Patient Portal
A digital patient portal for document management, homework tracking, and case progress.
Two Arizona Locations
Flagstaff and Lake Havasu City offices — serving pilots across the Southwest and beyond.