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On plans that kept the drug, Aetna's current policy (6947-C, P04-2025 revision) grants weight-loss authorization when all of the following hold: You have "participated in a comprehensive weight management program that encourages behavioral modification, reduced-calorie diet, AND increased physical activity with continuing follow-up for at least 6 months prior to using drug therapy." Your baseline BMI is 30 or higher or 27 or higher with at least one weight-related comorbid condition (the policy's examples: hypertension, type 2 diabetes, dyslipidemia)

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No established upper limit exists because excess b12 excretes through kidneys without causing harm

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