Plans want four things about each previous attempt: what you did, when, for how long, and what happened. “Patient has tried diet and exercise” is the single most common reason an otherwise-eligible request gets pended. A dated, specific history in your chart is usually the difference between approval and a month of back-and-forth.
This is one part of getting a GLP-1 covered. For the full picture, see GLP-1 Insurance Coverage: The Complete Guide.
What the plan is actually asking for
Most policies require evidence of a structured weight management attempt, and the required duration and recency window vary by plan. Check your plan’s clinical policy document rather than assuming a number.
The reviewer is not judging whether you tried hard. They are checking whether a specific documented episode exists in the record. That is a documentation problem, not a character test, and it is fixable.
The four elements
Every attempt you list should carry all four. Missing any one weakens it.
| Element | Weak | Strong |
|---|---|---|
| What | “Dieting” | “WW, commercial program with weekly weigh-ins” |
| When | “A few years ago” | “March 2024 to August 2024” |
| How long | “A while” | “Six months, continuous” |
| Outcome | “It didn’t work” | “Lost 18 lb, regained 22 lb by June 2025” |
The outcome line matters more than people expect. Regain after initial loss is clinically meaningful evidence. It demonstrates the pattern the medication is intended to address, rather than suggesting you simply did not follow through.
What counts as a program
Broader than most people assume. Commercial programs such as WW or Noom count, and both keep account histories you can export. Hospital or clinic weight management programs count and generate clinical records directly. Sessions with a registered dietitian count. A physician-supervised diet documented at visits counts.
Self-directed efforts are harder but not worthless. A food and weight log kept over months, gym attendance records, or an app export showing sustained tracking can all be attached as supporting evidence. They are weaker than supervised programs. They are considerably better than nothing.
List previous weight loss medications separately and specifically: the drug, the dose, how long you took it, and why you stopped. This doubles as the evidence base for a step therapy exception if one becomes necessary.
Your weight history worksheet
Fill this in before your appointment and hand it over. It saves the prescriber time and puts the specifics in front of them, rather than relying on recall in a fifteen-minute visit.
Baseline
Height: ______ · Current weight: ______ · Highest recorded weight: ______ (date: ______)
Where that highest weight was recorded: ____________________
Attempt 1
Program or method: ____________________
Start date: ________ End date: ________ Duration: ________
Supervised by: ____________________
Starting weight: ______ Lowest reached: ______ Weight when stopped: ______
Why it ended: ____________________
Records available: ____________________
Attempt 2 — repeat the block above
Medications previously tried for weight
Drug: ________ Dose: ________ Dates: ________ Outcome and reason stopped: ____________________
Weight-related conditions
Condition: ________ Diagnosed by: ________ Date: ________ Supporting test or result: ________
Getting it into the chart
Handing over a worksheet is not the same as it being documented. Ask explicitly: can this go into my chart as part of today’s note? A history that lives in a folder at reception does not reach the reviewer.
If records sit with a previous practice, request them yourself. Patients generally obtain their own records faster than practices obtain them from each other, and you have a right of access to them.
If you genuinely have no documented history
Some people have managed their weight for decades without any of it touching a medical record. That is common, and it is not a dead end.
Start the documentation now. A supervised attempt beginning today creates a record that will exist in three or six months, which matters if your plan has a duration requirement. Meanwhile, your prescriber can document a detailed history taken from you at the visit. A recorded patient-reported history is weaker than contemporaneous records, but it is legitimate documentation and some policies accept it explicitly.
Do not invent an attempt or a date. Beyond the obvious problem with that, a fabricated history that contradicts other records in your chart is more likely to sink the request than an honest thin one.
This documentation feeds two processes: the prior authorization itself and, if a preferred drug is demanded first, the step therapy exception. Keep it, because the renewal will need the same baseline a year later.
Frequently asked questions
How far back can attempts count?
Some policies impose a recency window. Others accept any documented history. Your plan’s clinical policy states which applies.
Does a gym membership count?
On its own, weakly. Combined with a food log and a documented plan, it strengthens the picture.
Do app screenshots work?
Exports with dates are better than screenshots. Anything with a verifiable date range is more useful than an image.
What if I lost weight and then regained it?
That is among the strongest histories you can present. Document both the loss and the regain, with dates.
Does bariatric surgery count as a prior attempt?
It is highly relevant and should always be documented, though coverage after surgery follows its own criteria.
Can my doctor just write that I tried?
They can, and it frequently gets pended. Specificity is what moves it.