1st Optimal vs He & She 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 →
He & She MD
Best for: Cheapest per-month GLP-1 if you can prepay a full year
Visit He & She MD →1st Optimal and He & She 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, both start around $99/mo, and He & She MD edges ahead overall (7.5 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.
He & She MD
Annual plan: billed $1,188 upfront. Advertised as a limited-time rate (banner: 'Injectable Semaglutide $199/month from just $99/month').
Billed $834 every 6 months, saving $360 vs monthly. Homepage GLP-1 Platinum starter rate: $139/mo for the first 6 months, then renews at $1,194 per 6 months, equivalent to $199/mo.
Billed $447 every 3 months, saving $270 vs monthly.
Billed monthly; the standing rate every term plan discounts from.
GLP-1 Platinum oral: $199/mo for the first 6 months, then renews at $1,434 per 6 months, equivalent to $239/mo. Oral is not on the /weight-loss/plans term ladder; figures from the homepage program cards and footnote 3.
Annual plan: billed $1,908 upfront.
Billed $1,194 every 6 months, saving $540 vs monthly. Homepage GLP-1 Platinum starter rate: $199/mo to start, then renews at $1,734 per 6 months, equivalent to $289/mo.
Billed $627 every 3 months, saving $270 vs monthly.
Billed monthly; the standing rate.
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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
He & She MD
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
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
He & She MD
7.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | He & She MD |
|---|---|---|
| Starting Price | $99/mo | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 50 |
| 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 He & She MD
He & She MD is a nationwide cash-pay telehealth clinic prescribing compounded semaglutide and tirzepatide, injectable or oral, plus brand-name access to Ozempic, Wegovy and Zepbound. Injectable semaglutide is $199/month billed monthly, falling to $139 on a six-month plan and $99 on the annual plan, prepaid for the year; tirzepatide runs $299/month down to $159 annually. Plans bundle medication, injection supplies, free shipping, unlimited provider messaging and GLP-1 coaching, and you are charged only if a clinician prescribes. Ships everywhere except Louisiana. LegitScript-certified.
Read our full He & She 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
He & She MD
What we like
- Injectable semaglutide from $99/month on the annual plan, or $139/month on a six-month plan
- Compounded semaglutide and tirzepatide, injectable or oral, plus brand access to Ozempic, Wegovy, Zepbound
- Only charged if medication is prescribed, and no membership fees
- Every plan includes medication, injection supplies, free shipping and unlimited provider messaging
- GLP-1 coaching, nutrition guidance, and in-app progress tracking
- LegitScript-certified, and it names both compounding pharmacies it uses
- Ships to 49 states (all except Louisiana)
Watch-outs
- Compounded GLP-1s are not FDA-approved finished products (per the site FDA disclaimer)
- Does not ship to Louisiana or to PO boxes
- The $99 and $159 headline rates require a full year prepaid in a single charge
- Month-to-month costs $199 for semaglutide and $299 for tirzepatide, roughly double the annual rate
- Six-month starter rates step up on renewal: semaglutide $139 to $199, tirzepatide $199 to $289
- Cash-pay model, insurance billing not indicated
Our Verdict
He & She MD edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for Cheapest per-month GLP-1 if you can prepay a full year. 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 He & She MD if…
You want Cheapest per-month GLP-1 if you can prepay a full year and a starting price around $99/mo.
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Get started →1st Optimal vs He & She 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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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.