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1st Optimal vs EllieMD

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
EllieMD logo

EllieMD

7.1
★★★3.6/5

Best for: mainstream telehealth GLP-1 access

Visit EllieMD

1st Optimal and EllieMD 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 $229/mo, and EllieMD edges ahead overall (7.1 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.

EllieMD

GLP-1 single agonist microdose — 12-week blockcompounded injection
$229/mo
semaglutide
GLP-1/GIP dual agonist microdose — 12-week blockcompounded injection
$239/mo
tirzepatide

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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

EllieMD

What the monthly price covers

Medication

Not disclosed

Provider visits

Included

Shipping

Included

Lab work

Billed separately

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

EllieMD

7.1/10

Value25%

6.5A
vs
B
6.5

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.0

Trust & Safety15%

6.5A
vs
B
7.0

Accessibility10%

6.5A
vs
B
7.5

Support10%

7.4A
vs
B
7.0

Features & Coverage

Feature1st OptimalEllieMD
Starting Price$99/mo$229/mo
Features8 features2 features
States AvailableNot disclosedNot disclosed
Compounded
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 EllieMD

EllieMD is a women-focused telehealth brand whose GLP-1 offer is a MICRODOSE program only: a single-agonist GLP-1 at $229/mo and a dual-agonist GLP-1/GIP at $239/mo, each sold as a 12-week block ($687 and $717) with an 84-day minimum commitment. A $50 non-refundable consultation is charged separately and does not include medication. Most of the product line is peptides and supplements rather than weight loss.

Read our full EllieMD 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

EllieMD

What we like

  • Both semaglutide and tirzepatide available

Watch-outs

  • Pricing not publicly disclosed

Our Verdict

Winner: EllieMD

EllieMD edges out 1st Optimal with a higher overall score of 7.1/10 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 EllieMD if…

You want mainstream telehealth GLP-1 access and a starting price around $229/mo.

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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

8.3

Found

Mainstream telehealth GLP-1 access

1st Optimal vs EllieMD: FAQ

1st Optimal is cheaper. Its lowest ongoing monthly cash price is $99/mo, compared with $229/mo for EllieMD. We compare standing (not first-month promo) prices so the figures reflect what you'd actually pay month to month.
EllieMD scores higher overall at 7.1/10 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.
Neither 1st Optimal nor EllieMD publicly lists its exact state availability. Most national GLP-1 telehealth providers operate in the majority of states — confirm your state is covered during sign-up.
Neither 1st Optimal nor EllieMD is currently an affiliate partner, so we earn no commission from either. We rank all providers editorially using the same six-dimension framework and disclose any commercial relationships.
For Semaglutide, 1st Optimal is cheaper at $99/mo versus $229/mo at EllieMD.

Key terms, explained

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

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