1st Optimal vs Cielo
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 programCielo
Best for flat-rate compounded GLP-1 at the lowest 3-month bundle pricesStarting at $115/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Cielo |
|---|---|---|
| Overall Score | 6.7/10 | ✓7.5/10 |
| Starting Price | — | $115/mo |
| Editorial Rating | 3.4 ★ /5 | ✓3.8 ★ /5 |
| Features | 8 features | 8 features |
| States Available | 0 | 0 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
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
Cielo
Pros
- ✓Among the lowest 3-month bundle prices in compounded GLP-1 ($115/mo semaglutide)
- ✓Single flat price across all doses simplifies titration planning
- ✓Corporate address (St. Petersburg, FL) and customer-service phone published
Cons
- ✗No LegitScript, NABP .pharmacy, or HIPAA badge on the home page
- ✗Pharmacy partner not named (only 'regulated FDA pharmacy partners')
- ✗State coverage list not published — can't verify all-50-state availability
- ✗Clinical care runs through MD Integrations, a shared third-party network used by many brands
- ✗No brand-name Wegovy or Zepbound option
- ✗Donation page shows 0% next to a 10%-pledge claim — an apparent discrepancy
Our Verdict
Cielo edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for flat-rate compounded GLP-1 at the lowest 3-month bundle prices. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
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.