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1st Optimal vs Defy Medical

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
Defy Medical logo

Defy Medical

7.0
★★★3.5/5

Best for: Patients wanting GLP-1 in injection, ODT, or drop forms with thorough lab workups

Visit Defy Medical

1st Optimal and Defy Medical 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, Defy Medical edges ahead overall (7.0 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.

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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

Defy Medical

7.0/10

Value25%

6.5A
vs
B
6.5

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
6.5

Trust & Safety15%

6.5A
vs
B
7.0

Accessibility10%

6.5A
vs
B
7.0

Support10%

7.4A
vs
B
7.4

Features & Coverage

Feature1st OptimalDefy Medical
Starting Price
Features8 features8 features
States AvailableNot disclosedNot disclosed
Compounded
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 Defy Medical

Defy Medical is a long-running telehealth clinic, best known for hormone replacement, that also prescribes GLP-1 medications for weight loss. It offers semaglutide and tirzepatide as weekly injections plus oral disintegrating tablets (ODT) and liquid drops, and liraglutide as a daily injection. The drops and ODT forms help patients avoid self-injecting or get treatment where injectable shipping is restricted. Care includes in-depth consults and comprehensive blood testing, with mobile phlebotomy. Medical director is Dr. Justin Saya. GLP-1 pricing and state coverage are not published online.

Read our full Defy Medical 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

Defy Medical

What we like

  • Multiple GLP-1 options: semaglutide, tirzepatide, liraglutide
  • Offers injection, ODT, and oral drop delivery forms
  • Comprehensive blood testing and named medical director
  • Established clinic with strong Trustpilot review volume

Watch-outs

  • GLP-1 pricing not published on the website
  • States served and shipping limits not disclosed
  • Compounded versus brand status not stated online
  • Lab-heavy, consult-first model may cost more upfront

Our Verdict

Winner: Defy Medical

Defy Medical edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for Patients wanting GLP-1 in injection, ODT, or drop forms with thorough lab workups. 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 Defy Medical if…

You want Patients wanting GLP-1 in injection, ODT, or drop forms with thorough lab workups.

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7.4

MadeMed

Compounded GLP-1 in both injection and oral forms

8.3

Found

Mainstream telehealth GLP-1 access

7.4

Breeze Meds

Compounded GLP-1 access with named prescribers and 4-pharmacy network

1st Optimal vs Defy Medical: FAQ

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