1st Optimal vs Fitstry
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 program
Visit 1st Optimal →
Fitstry
Best for: transparent compounded semaglutide, tirzepatide or oral GLP-1 for women 40+ with a refundable $99 intake
Visit Fitstry →1st Optimal and Fitstry 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, Fitstry starts at $169/mo, and Fitstry 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.
Fitstry
Compounded semaglutide from $179/mo on the annual plan, or $249/mo month-to-month; the $99 program fee (refunded if not approved) applies before your first order.
Compounded tirzepatide from $269/mo on the annual plan, or $339/mo month-to-month.
Daily oral GLP-1 tablets from $209/mo on the annual plan, or $279/mo month-to-month; the molecule isn't named publicly.
Microdosing options start at $169/mo; the exact price and molecule are confirmed after the free screening.
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What’s included
1st Optimal
Inclusions not disclosed.
Fitstry
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
Fitstry
6.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Fitstry |
|---|---|---|
| Starting Price | — | $169/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| 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 Fitstry
Fitstry is the GLP-1 weight-loss program of Weightstry, LLC, a LegitScript-certified, cash-pay telehealth practice focused on women 40+. It offers compounded semaglutide and tirzepatide as weekly injections, a daily oral GLP-1 tablet, and microdosing. You begin with a free screening and pay a one-time program fee only if you qualify, refunded if a clinician can't prescribe. The monthly medication price bundles a lab panel, unlimited clinician access, bi-weekly care coaching, a 24/7 Care Line and free discreet shipping. Fitstry serves 49 states; compounded medications are not FDA-approved.
Read our full Fitstry 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
Fitstry
What we like
- Transparent pricing before you commit — compounded semaglutide from $179/mo, tirzepatide from $269/mo, oral GLP-1 from $209/mo (annual plan)
- Free screening with a one-time $99 program fee that is fully refunded if a clinician can't prescribe ('Approved, or Your $99 Back')
- Monthly price bundles a lab panel (CMP, A1c, lipids, TSH), unlimited clinician access, bi-weekly care coaching and a 24/7 Care Line
- Runs under Weightstry, LLC, a LegitScript-certified practice with an independently verifiable seal, a named support email and phone
- Full compounded lineup — weekly injection, daily oral tablet and microdosing options
Watch-outs
- Month-to-month pricing is notably higher than the annual plan ($249 vs $179 semaglutide, $339 vs $269 tirzepatide)
- Compounded semaglutide and tirzepatide only — no brand-name (Wegovy/Zepbound) options
- Framed for women 40+, and serves 49 states rather than all 50 (the excluded state isn't disclosed publicly)
- Works with state-licensed compounding pharmacies but doesn't name a specific pharmacy partner on the Fitstry page
- Compounded GLP-1s are not FDA-reviewed or approved — a different evidence and regulatory tier than brand-name
Our Verdict
Fitstry edges out 1st Optimal with a higher overall score of 6.9/10 and is particularly strong for transparent compounded semaglutide, tirzepatide or oral GLP-1 for women 40+ with a refundable $99 intake. 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 Fitstry if…
You want transparent compounded semaglutide, tirzepatide or oral GLP-1 for women 40+ with a refundable $99 intake and a starting price around $169/mo.
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Get started →1st Optimal vs Fitstry: 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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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.