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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: Patients wanting 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, bmiMD starts at $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

Pricing not publicly listed.

bmiMD

Compounded semaglutide injection (all doses, flat)Compounded
$99/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
$139/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

Inclusions not disclosed.

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
Features8 features2 features
States AvailableNot disclosed50
Compounded✓ Yes
Brand Name
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

  • Pricing not publicly disclosed

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 Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Choose 1st Optimal if…

You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Choose bmiMD if…

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

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7.6

SkinnyRx

Mainstream telehealth GLP-1 access

7.3

Sunlight

Compounded GLP-1 with unlimited telehealth visits and free shipping

7.4

MadeMed

Compounded GLP-1 in both injection and oral forms

1st Optimal vs bmiMD: FAQ

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