1st Optimal vs Bionomy Health
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →Bionomy Health
Best for: men wanting physician-led GLP-1 plus TRT and longevity add-ons
Visit Bionomy Health →1st Optimal and Bionomy Health are both GLP-1 Providers competing for the same patients, but they make different trade-offs on price, coverage, and what's included. In our scoring, 1st Optimal starts lower at $99/mo versus $189/mo, and Bionomy Health edges ahead overall (7.4 vs 6.7 out of 10). Below we break down pricing, what each plan covers, the six-dimension score, pros and cons, and exactly who should pick which.
Pricing
1st Optimal
Care membership only — the GLP-1 medication is billed separately and is not priced.
Bionomy Health
Pay per prescription, no subscription; billed monthly
Pay per prescription, no subscription; billed monthly
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What’s included
1st Optimal
What the monthly price covers
Medication
Not disclosed
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
Bionomy Health
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Not disclosed
Score breakdown
Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.
1st Optimal
6.7/10
Bionomy Health
7.4/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Bionomy Health |
|---|---|---|
| Starting Price | ✓$99/mo | $189/mo |
| Features | ✓8 features | 7 features |
| States Available | Not disclosed | 48 |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
About 1st Optimal
1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets. Its model pairs prescription GLP-1 therapy with at-home lab testing, blood-work interpretation, unlimited coaching, and personalized protocols framed around long-term weight loss and longevity. Care is delivered virtually by credentialed providers, and treatments ship to the home with no long-term contracts. The site does not publish monthly pricing or a state list.
Read our full 1st Optimal review →About Bionomy Health
Bionomy Health is a physician-led, direct-to-consumer men's telehealth brand offering compounded GLP-1 weight-loss medication alongside testosterone, peptides, and longevity protocols. It prescribes compounded semaglutide (189 dollars a month) and compounded tirzepatide (249 dollars a month) on a pay-per-prescription basis with no subscription. The intake is free and physician-reviewed before you pay, and it reaches 48 states (all except Alaska and Hawaii). Compounded medications are fulfilled by LegitScript-certified pharmacies Strive and Absolute. Compounded drugs are not FDA-approved.
Read our full Bionomy Health review →Pros & Cons
1st Optimal
What we like
- 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
Watch-outs
- 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
Bionomy Health
What we like
- Offers both compounded semaglutide (189/mo) and tirzepatide (249/mo) with pay-per-prescription pricing and no subscription
- Physician-led with a free, physician-reviewed intake before you pay anything
- Fills through LegitScript-certified compounding pharmacies Strive and Absolute; available in 48 states
- Pairs GLP-1 protocols with muscle-preserve supplements and a written training note to protect lean mass
Watch-outs
- Men's health brand, so the site framing and protocols are geared to men rather than a general audience
- New brand launched in 2026 with limited independent reviews and track record
- Not available in Alaska or Hawaii; compounded medications are not FDA-approved
Our Verdict
Bionomy Health edges out 1st Optimal with a higher overall score of 7.4/10 and is particularly strong for men wanting physician-led GLP-1 plus TRT and longevity add-ons. 1st Optimal remains a solid alternative, especially if you're looking for GLP-1 therapy within a lab-driven functional-medicine program.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Bionomy Health if…
You want men wanting physician-led GLP-1 plus TRT and longevity add-ons and a starting price around $189/mo.
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Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →Breeze Meds
Compounded GLP-1 access with named prescribers and 4-pharmacy network
From $199/mo
Get started →Telos Rx
Needle-free, microdosed compounded GLP-1 with lab-monitored care
From $99/mo
Get started →1st Optimal vs Bionomy Health: FAQ
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- 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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