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FAA CACI Weight Loss Medication (GLP-1) Worksheet

Pilots using medication for obesity or overweight, including diabetic drugs taken for weight loss, can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist. The AME reviews a progress note from a visit within 90 days of the exam and checks the medication, side effects and glucose history. A pilot whose A1C has ever been 6.5% or higher cannot use it.

Who completes it

The AME completes the checklist and marks the Block 60 outcome. The prescribing provider or treating physician writes the current, detailed Clinical Progress Note the AME reviews.

Submitting and payment

How to submit it
A qualifying case is noted as 'CACI qualified weight loss management' in Block 60 of FAA Form 8500-8. If any item is not met, the AME defers and submits the supporting documents to the FAA.

Good to know

  • Only one medication may be used: metformin, liraglutide, orforglipron (Foundayo), semaglutide (Wegovy, injection or oral) or tirzepatide (Zepbound).
  • The AME verifies a one-week observation after starting the medication and a 48-hour observation after each dose increase, medication or formulation change.
  • If A1C is in the prediabetic range of 5.7 to 6.4%, the Prediabetes CACI applies instead. Diabetes in remission, treated diabetes and diabetes insipidus do not qualify.
  • There can be no hypoglycemic events (symptoms or glucose 70 mg/dL or less) requiring intervention in the past 12 months, no diabetes symptoms or complications and no side effects.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Weight Loss Management Worksheet (Use of Medication for Obesity or Overweight)

Official pagePDF

Fill it with Vero

If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Which weight loss drugs does the FAA CACI accept?

One medication from this list: metformin, liraglutide, orforglipron (Foundayo), semaglutide (Wegovy, injection or oral) or tirzepatide (Zepbound). The AME verifies a one-week observation after starting it and 48 hours after each dose increase, medication or formulation change, and the pilot must have no side effects.

What if the pilot's A1C is in the prediabetes range?

The worksheet directs pilots with an A1C between 5.7% and 6.4% to the Prediabetes CACI instead. If the A1C has ever been 6.5% or greater, this CACI cannot be used, and diabetes in remission, diabetes treated with medication and diabetes insipidus do not qualify either.