A first GLP-1 consultation in Singapore is a history. The doctor asks what you take, what conditions you have, what has happened before, and what you are trying to do — because Singapore's medical regulator requires a doctor to have sufficient information from good history-taking before offering any opinion or treatment. The rules also set the shape of the conversation: a first-time patient must be seen by real-time two-way video, and a medicine cannot be prescribed on the strength of a filled-in questionnaire. This article covers what gets asked, why each part is there, and what is actually known about the parts people leave out.
First-time patient: in Singapore's outpatient regulations, a patient who has not previously received an outpatient medical service from that licensee. The definition matters because it triggers the live-video requirement.
What the rules require before the consultation begins
Three things, and they happen before any clinical question is asked.
Before providing any service remotely, a licensee must ascertain the patient's identity, contact information and location; inform the patient that essential life-saving measures should not be sought remotely; and inform the patient who will be providing the service and in what role. The provider must also hold written guidelines on the type of patient suited to remote care, taking into account the patient's condition and history, the practitioner's competence, and the patient's own ability to receive the service that way (OMS Regulations).
The consultation itself is specified. A licensee must not provide a service remotely to a first-time patient unless it is "through real-time 2-way interactive audiovisual communications", and the video consultation must be conducted in a place that is closed and private, with sufficient lighting and equipment, and with the patient having a full view of the practitioner's face (OMS Regulations).
The joint circular issued by MOH, HSA and the Singapore Medical Council says the same in plainer language, and adds the part that people find most surprising: "Teleconsultations must not be provided solely by way of self-service, text-only questions", and medicines "should not be prescribed... just by getting a patient to fill-up a questionnaire" (Circular 87/2024).
What the circular says about this medicine specifically
It names it — and the naming is often read backwards.
Among the medicine types a telemedicine licensee's own written guidelines must address, the circular gives as an example "medications requiring the patients to be first taught to be proficient in its use (such as bronchodilators in asthma or insulin or GLP-1 injections)" (Circular 87/2024).
Read that precisely. It places a duty on the provider to have thought about, and written down, when prescribing such a medicine remotely is and is not appropriate. It is not a restriction on the medicine, and it does not say GLP-1 medication cannot be prescribed by telemedicine. What it does say is that a regulator has put this class in the same sentence as inhalers and insulin, on the grounds that the patient has to be taught to use it — which is a statement about the category being one that needs teaching, not a warning about the drug.
What the doctor asks, and what each part is for
Five areas, and each of them changes the answer to a different question.
Current medicines and supplements. Some medicines need attention when gastric emptying slows or when eating patterns change substantially. That is a question the doctor has to ask rather than infer, and it covers over-the-counter products and supplements as well as prescriptions. We cover the detail in GLP-1 medication and drug interactions.
Existing conditions and past medical history. Singapore's registered product information lists hypersensitivity to the active substance or the excipients as its only stated contraindication (Singapore formulary) — a short list, which is precisely why the rest of the history does the work. Who should not take GLP-1 medication sets out what sits outside that single line.
Family history. Relevant for reasons that differ between jurisdictions, and worth answering fully even where you are not sure of the details.
Height, weight and weight history. Singapore runs two BMI scales at once, and both are correct. The national obesity guideline classifies overweight from 23 and obesity from 27.5 for the local population (HPB-MOH 2016), while the registered product information sets its own thresholds for the weight-management indication. A number crossing a line is a reason for a conversation rather than the outcome of one, and the reasoning behind the local scale is covered in why Asian BMI thresholds are lower.
Pregnancy, breastfeeding and plans for either. Timing matters here and the guidance differs by medicine and by country, so this is a question to answer with the actual plan rather than the current situation.
Why the doctor asks things you have already typed in
Because the assessment belongs to the doctor, not to the form.
Singapore's Ethical Code and Ethical Guidelines put it as a duty: "You must ensure that you have sufficient information about your patients, derived from good history-taking, adequate clinical examination and other relevant investigations or information sources, before you offer any opinion, make management plans or offer treatment" (SMC). The same code addresses remote care directly — telemedicine "is not equal to conventional in-person care and has to be provided in a responsible manner", a doctor must "endeavour to provide the same quality and standard of care as in-person medical care", and patients must be given enough information about telemedicine's limitations to consent to it (SMC).
Worth noting what that code does and does not cover. It is written entirely as duties on the doctor. It says nothing at all about what patients owe the conversation. The case for answering fully is ours to make, and the next section is where we make it.
Most people leave something out, and we know why
Two US surveys of 4,510 adults asked directly. In one sample 81.1% and in the other 61.4% had avoided disclosing at least one type of medically relevant information to a clinician. The commonest omissions were disagreeing with the clinician's recommendation (45.7% and 31.4%) and not understanding the clinician's instructions (31.8% and 24.3%). The commonest reasons were not wanting to be judged or lectured (81.8% and 64.1%), not wanting to hear how harmful the behaviour is (75.7% and 61.1%), and embarrassment (60.9% and 49.9%). Women, younger respondents and those with worse self-rated health were more likely to withhold (Levy 2018).
Two limits on that study, both worth stating. The samples are American, non-probability and overwhelmingly white, so the percentages do not transfer to Singapore. And the study measured self-reported behaviour and stated reasons only — no clinical outcome was assessed. A search for any study linking patient non-disclosure to a measured outcome, such as an adverse event or worse control of a condition, found none.
So the claim that being candid improves your result has never been demonstrated by anyone, and it does not appear in this article as though it had been. What can be said is narrower and, we think, more useful: the assessment is built out of what the doctor is told, so anything left out is simply not in it. If you disagree with a recommendation, saying so is more useful than agreeing and then not following it — that was the single commonest thing people in the study withheld. If you did not follow something, the doctor needs the actual sequence rather than the intended one.
And the top three reasons people withhold are all about anticipated judgement. It is worth knowing that the assessment is not a test you pass or fail, and that a doctor who has heard the whole picture is working with the situation as it is.
What happens if the doctor needs something video cannot give
They arrange it, and the regulations require them to.
Where a practitioner is of the opinion that a patient requires treatment, care or a physical examination that cannot be carried out remotely, the licensee must make alternative arrangements for the patient to receive it and inform the patient accordingly (OMS Regulations). The joint circular states the same boundary from the clinician's side: "Patients or conditions which require a more comprehensive and detailed physical examination for adequate clinical assessment should not be managed via teleconsultation", and after a teleconsultation the licensee must inform patients about follow-up care and make arrangements for in-person follow-up where that is deemed necessary (Circular 87/2024).
If a doctor wants further checks at a physical clinic before prescribing, that is a normal step, not a rejection — and it does not mean GLP-1 medication is off the table. It usually means something is worth confirming so that treatment can start safely. Blood tests are a common form of that, and the position on them is narrower than most people expect: blood tests and GLP-1 sets out what the labels do and do not require.
What the consultation itself looks like from your side is described in what happens at a GLP-1 video consultation.
Individual circumstances vary, and whether treatment is appropriate for you is a decision for the doctor who has assessed you.
Common questions
What will the doctor ask at a GLP-1 consultation?
Your medical history, the medicines and supplements you currently take, existing conditions, family history, and what you have tried before. Singapore's medical regulator requires a doctor to have sufficient information from good history-taking before offering any opinion or treatment (SMC).
Does a first GLP-1 consultation have to be on video?
Yes, if you are a first-time patient of that provider. The regulations prohibit remote provision to a first-time patient unless it is through real-time two-way interactive audiovisual communications (OMS Regulations).
Can a clinic prescribe GLP-1 medication from a questionnaire alone?
No. The joint regulator circular states that teleconsultations must not be provided solely by way of self-service, text-only questions, and that medicines should not be prescribed just by getting a patient to fill up a questionnaire (Circular 87/2024).
Is GLP-1 medication restricted from telemedicine in Singapore?
No. The joint circular names GLP-1 injections as an example of a medicine class a licensee's own written guidelines must address, alongside inhalers and insulin, because the patient has to be taught to use it. That is a duty to hold a protocol, not a prohibition (Circular 87/2024).
Does being honest with the doctor improve the result?
Nobody has measured that. The available research counts how often people withhold information and why — most respondents in two US surveys of 4,510 adults did, most often to avoid being judged or lectured (Levy 2018) — but no study links non-disclosure to a measured clinical outcome.