1st Optimal vs Enhance MD
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
Enhance MD
Best for: lab-monitored compounded GLP-1 with mandatory video visit
Visit Enhance MD →1st Optimal and Enhance MD 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 $169/mo, and Enhance MD edges ahead overall (8.2 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
Care membership only — the GLP-1 medication is billed separately and is not priced.
Enhance MD
$212/mo is the 12-month-plan rate (billed every 48 weeks). 6-mo $224/mo, 3-mo $237/mo, 1-mo $249/mo. First month $112 = $100 off first order on 3+ month plans (code SUMMER100); $50 off 1-month (SUMMER50). Flat price at all doses; labs, consult, 2-day shipping included.
$280/mo = 12-month-plan rate. 6-mo $296/mo, 3-mo $313/mo, 1-mo $329/mo. First month $180 via $100-off first order (SUMMER100). Flat all-dose pricing.
Combined semaglutide + tirzepatide. $322/mo = 12-month-plan rate. 6-mo $341/mo, 3-mo $360/mo, 1-mo $379/mo. First month $222 via SUMMER100.
Low-dose tier, and it is prepay-only: 12-month $169/mo, 6-month $179/mo, 3-month $189/mo. No one-month option is offered for microdosing at all.
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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
Enhance MD
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Not disclosed
Lab work
Included
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
Enhance MD
8.2/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Enhance MD |
|---|---|---|
| Starting Price | ✓$99/mo | $169/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | 39 |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
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 Enhance MD
Enhance MD pairs compounded semaglutide and tirzepatide with mandatory baseline metabolic labs at Quest Diagnostics and a synchronous video visit with a board-certified clinician — a more rigorous onboarding than the async-only compounded GLP-1 model most telehealth providers use. Three tiers (Core semaglutide, Advanced tirzepatide, Elite combined) plus $100-off-first-order intro pricing ($112 first month on Core with code SUMMER100).
Read our full Enhance MD 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
Enhance MD
What we like
- Baseline and ongoing metabolic labs (CMP, lipids, TSH, HbA1c) at Quest every 6 months — rare for compounded GLP-1
- Mandatory video visit with a US-licensed MD or NP before your first prescription — not a pure questionnaire model
- Three tiers, including a combined semaglutide + tirzepatide Elite plan ($322/mo) for patients plateaued on one GLP-1
- Uses LegitScript-certified 503A pharmacies (Tru Meds Rx, Strive Pharmacy, Pharmacy Hub)
- Intro pricing via $100 off your first order (code SUMMER100): $112 Core, $180 Advanced, $222 Elite first month
- Unlimited clinician messaging and dose-adjustment support included
Watch-outs
- Compounded only — no FDA-approved Ozempic, Wegovy, Zepbound, or Mounjaro
- Not available in 10 states: AL, AR, GA, HI, LA, MS, MO, SC, TN, WV
- Mandatory lab work adds 5–10 days to onboarding vs async-only competitors
- No insurance accepted — cash pay, HSA/FSA eligible
- Intro discount applies only to the first order — ongoing rates are $212–$322/mo on 12-month plans, or $249–$379/mo month-to-month
Our Verdict
Enhance MD edges out 1st Optimal with a higher overall score of 8.2/10 and is particularly strong for lab-monitored compounded GLP-1 with mandatory video visit. 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 Enhance MD if…
You want lab-monitored compounded GLP-1 with mandatory video visit and a starting price around $169/mo.
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Get started →1st Optimal vs Enhance MD: FAQ
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- 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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