1st Optimal vs AM Rx
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine programAM Rx
Best for patients with insurance seeking brand-name GLP-1 access (review regulatory warnings carefully)Starting at $25/mo
Side-by-Side Comparison
| Feature | 1st Optimal | AM Rx |
|---|---|---|
| Overall Score | ✓6.7/10 | 5.9/10 |
| Starting Price | — | $25/mo |
| Editorial Rating | ✓3.4 ★ /5 | 3 ★ /5 |
| Features | ✓8 features | 7 features |
| States Available | 0 | 0 |
| Compounded | — | ✓ Yes |
| Brand Name | — | ✓ Yes |
| FSA/HSA Accepted | — | — |
| FDA Warnings | ✓None | 2 warnings |
Pros & Cons
1st Optimal
Pros
- ✓Offers both semaglutide and tirzepatide with injectable and oral formats
- ✓Functional-medicine approach with at-home labs and blood-work interpretation
- ✓Unlimited coaching and ongoing support included
- ✓No long-term contracts
- ✓Board-certified doctors and nurse practitioners referenced
Cons
- ✗No public monthly pricing disclosed
- ✗No published state availability list
- ✗Compounded vs branded sourcing not clarified on site
- ✗Pricing only revealed after quiz or consultation
AM Rx
Pros
- ✓Insurance coordination for brand-name GLP-1s — as low as $25/mo
- ✓All four major brand-name GLP-1s available (Ozempic, Wegovy, Zepbound, Mounjaro)
- ✓HSA and FSA accepted
- ✓Video visits available with providers averaging 10+ years' experience
- ✓Compounded semaglutide from $151/mo on the quarterly plan
Cons
- ✗Active FTC/DOJ lawsuit over deceptive billing and subscription practices
- ✗Two FDA warning letters (Sept 2025, Feb 2026) for misbranding compounded GLP-1s
- ✗Novo Nordisk false-advertising lawsuit (Aug 2025)
- ✗Parent company Zealthy holds a BBB D- rating with 2,370+ complaints
- ✗Trustpilot 2.0/5, with 85% one-star reviews citing billing disputes and unreachable support
- ✗No named pharmacy partners, no LegitScript certification, and no FDA compounding disclaimer on the site
Our Verdict
1st Optimal edges out AM Rx with a higher overall score of 6.7/10 and is particularly strong for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. AM Rx remains a solid alternative, especially if you're looking for patients with insurance seeking brand-name GLP-1 access (review regulatory warnings carefully).
Glossary references
Key terms in this article, linked to their canonical definitions.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
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Or see the full category ranking.
Wegovy®, Ozempic®, and Rybelsus® are trademarks of Novo Nordisk A/S. Mounjaro® and Zepbound® are trademarks of Eli Lilly and Company. All other product names and trademarks referenced on this page belong to their respective owners. WeightLossRankings.org is not affiliated with any pharmaceutical manufacturer. See trademark disclaimer.