GLP-1 RA Eligibility in Reproductive-Age U.S. Women

OBJECTIVE Use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for diabetes or weight management may affect pregnancy outcomes. We sought to estimate the number of U.S. women of reproductive age eligible for GLP-1 RA therapy. RESEARCH DESIGN AND METHODS Using 2017–2023 nationally representative survey data, we identified nonpregnant U.S. women aged 18–44 years who met trial-based eligibility criteria for diabetes, weight management, or secondary cardiovascular prevention. RESULTS Among 3,218 participants, 1,447 were eligible for GLP-1 RAs, representing 24.6 million U.S. women. Among GLP-1 RA–eligible women, mean BMI was 34.8 kg/m2, 8.3% had diabetes, and 1.9% had prior cardiovascular disease. Eligibility was primarily for weight management (24.1 million), followed by diabetes (2.0 million) and cardiovascular prevention (0.34 million). CONCLUSIONS Nearly half of U.S. reproductive-age women are eligible for GLP-1 RAs. Given limited pregnancy safety data and rising cardiometabolic burden in reproductive-age women, research is needed to guide counseling and coverage of preconception GLP-1 RA use.