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1st Optimal vs eMI Aesthetics

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

eMI Aesthetics

6.9
★★★3.5/5

Best for: shoppers wanting compounded sema or tirz in all 50 states with an ai progress simulator

Visit eMI Aesthetics

1st Optimal and eMI Aesthetics 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, eMI Aesthetics starts at $179/mo, and eMI Aesthetics edges ahead overall (6.9 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.

eMI Aesthetics

All doses (flat)Compounded
$179/mo
semaglutide

Advertised starting rate ('start as low as 179/month'); actual price varies by drug and plan length

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What’s included

1st Optimal

Inclusions not disclosed.

eMI Aesthetics

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

eMI Aesthetics

6.9/10

Value25%

6.5A
vs
B
6.5

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
6.0

Trust & Safety15%

6.5A
vs
B
6.5

Accessibility10%

6.5A
vs
B
9.0

Support10%

7.4A
vs
B
6.0

Features & Coverage

Feature1st OptimaleMI Aesthetics
Starting Price$179/mo
Features8 features6 features
States AvailableNot disclosed51
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 eMI Aesthetics

eMI Aesthetics is a US direct-to-consumer telehealth brand offering doctor-guided GLP-1 weight loss programs to eligible patients in all 50 states. It provides compounded semaglutide injection, tirzepatide injection, and an oral semaglutide option, plus lower micro-dose longevity plans, sold as 4, 12, 24, and 52-week programs starting as low as 179 dollars per month. Intake and clinician visits run through OpenLoop Health, an established telehealth network. Full per-drug pricing is not shown before intake, and no fill pharmacy or named medical director is published.

Read our full eMI Aesthetics 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

eMI Aesthetics

What we like

  • Available to eligible patients in all 50 states
  • Offers both semaglutide and tirzepatide, plus an oral semaglutide option
  • Intake and provider visits run through OpenLoop Health, an established telehealth network

Watch-outs

  • Full per-drug pricing is not shown before intake; only an 'as low as 179/month' starting rate is published
  • No fill pharmacy or named medical director is publicly listed
  • Support appears limited to email, with no phone number or hours published

Our Verdict

Winner: eMI Aesthetics

eMI Aesthetics edges out 1st Optimal with a higher overall score of 6.9/10 and is particularly strong for shoppers wanting compounded sema or tirz in all 50 states with an ai progress simulator. 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 eMI Aesthetics if…

You want shoppers wanting compounded sema or tirz in all 50 states with an ai progress simulator and a starting price around $179/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 eMI Aesthetics: FAQ

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