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1st Optimal vs bmiMD

An in-depth comparison of two leading GLP-1 Providers

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

6.7
★★★☆☆3.4/5

Best for: GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS
bmiMD logo

bmiMD

8.1
★★★★4.1/5

Best for: mainstream telehealth GLP-1 access

Visit bmiMD

1st Optimal and bmiMD 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, both start around $99/mo, and bmiMD edges ahead overall (8.1 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

Weight Loss Care membership — medication not includedBrand-name
$99/mo
semaglutide

Care membership only — the GLP-1 medication is billed separately and is not priced.

bmiMD

Compounded semaglutide injection (all doses, flat)Compounded
$119/mo
semaglutide

Ladder by plan length: 12 mo $99/mo (Total $1,188.00), 6 mo $109/mo, 3 mo $119/mo, 1 mo $129/mo. 'Same price at every dose'; provider visit + free shipping included. Verified 2026-07-14 at bmimd.com/personalized-glp-1/ and /semaglutide-injection/.

Compounded tirzepatide injection (all doses, flat)Compounded
$179/mo
tirzepatide

Ladder by plan length: 12 mo $139/mo (Total $1,668.00), 6 mo $149/mo, 3 mo $159/mo, 1 mo $179/mo. Same flat-dose model. Verified 2026-07-14 at bmimd.com/tirzepatide-injection/.

Semaglutide Microdose (new product line)Compounded
$99/mo
semaglutide

Strike-through pricing shown: $151.20 -> $99/mo (12-mo) up to $199.80 -> $129/mo (monthly), labeled 'Limited time offer'. bmimd.com/glp-1-microdose/.

Tirzepatide Microdose (new product line)Compounded
$139/mo
tirzepatide

Strike-through pricing shown: $250.20 -> $139/mo (12-mo) up to $299.70 -> $179/mo (monthly), labeled 'Limited time offer'. bmimd.com/glp-1-gip-microdose/.

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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

bmiMD

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

Overall

bmiMD

8.1/10

Value25%

6.5A
vs
B
9.0

Effectiveness25%

7.0A
vs
B
8.0

User Experience15%

6.5A
vs
B
7.5

Trust & Safety15%

6.5A
vs
B
7.3

Accessibility10%

6.5A
vs
B
8.5

Support10%

7.4A
vs
B
8.0

Features & Coverage

Feature1st OptimalbmiMD
Starting Price$99/mo$99/mo
Features8 features2 features
States AvailableNot disclosed50
Compounded✓ Yes
Brand Name✓ Yes
FSA/HSA Accepted
FDA WarningsNoneNone

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 bmiMD

Medical weight loss clinic offering GLP-1 prescriptions through telehealth.

Read our full bmiMD 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

bmiMD

What we like

  • Both semaglutide and tirzepatide available

Watch-outs

  • Cheapest advertised rates require a 12-month prepaid plan — month-to-month is $129 for semaglutide and $139 for sermorelin injection

Our Verdict

Winner: bmiMD

bmiMD edges out 1st Optimal with a higher overall score of 8.1/10 and is particularly strong for mainstream telehealth GLP-1 access. 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 bmiMD if…

You want mainstream telehealth GLP-1 access and a starting price around $99/mo.

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8.3

Found

Mainstream telehealth GLP-1 access

7.1

Bodybuilding Health+

Fitness-brand compounded GLP-1 with hormone and performance programs

7.4

Brightmeds

Compounded or brand GLP-1 bundled with TRT and peptides for men

1st Optimal vs bmiMD: FAQ

1st Optimal and bmiMD have the same lowest ongoing monthly price of $99/mo, so price alone won't separate them — compare what each plan includes instead.
bmiMD scores higher overall at 8.1/10 versus 6.7/10, and is particularly strong for mainstream telehealth GLP-1 access. That said, 1st Optimal is a better fit if you want GLP-1 therapy within a lab-driven functional-medicine program.
bmiMD lists availability in 50 states, while 1st Optimal's state list is not publicly listed.
bmiMD is an affiliate partner (we may earn a commission on sign-ups through our links); 1st Optimal is not. Either way, we rank providers editorially with the same scoring framework and disclose every partnership — being a partner does not buy a higher score.
1st Optimal and bmiMD list the same lowest price for Semaglutide: $99/mo.

Key terms, explained

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Continue exploring 1st Optimal and bmiMD head-to-heads in the same category.

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