1st Optimal vs Knownwell
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 →
Knownwell
Best for: Patients wanting branded GLP-1s with obesity-medicine oversight and insurance options
Visit Knownwell →1st Optimal and Knownwell 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, Knownwell starts at $349/mo, and Knownwell edges ahead overall (7.7 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.
Knownwell
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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
Knownwell
7.7/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Knownwell |
|---|---|---|
| Starting Price | — | $349/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 50 |
| Compounded | — | — |
| 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 Knownwell
Knownwell is a weight-inclusive metabolic and primary care company co-founded by obesity-medicine specialist Dr. Angela Fitch. It offers branded GLP-1 medications including Wegovy, Zepbound, Ozempic and Saxenda, plus the oral GLP-1 Foundayo, via virtual visits in all 50 states and in-person clinics in Boston, Chicago, Dallas-Fort Worth and Atlanta. Knownwell is a LillyDirect care provider and a Novo Nordisk telehealth partner for the Wegovy pill. Care combines physician oversight with dietitians and coaches. Many insurance plans are accepted, with copays as low as $25 for covered patients.
Read our full Knownwell 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
Knownwell
What we like
- Co-founded by obesity-medicine specialist Dr. Angela Fitch
- Branded FDA-approved GLP-1s (Wegovy, Zepbound, Ozempic, Saxenda)
- Official LillyDirect provider and Novo Wegovy-pill telehealth partner
- Accepts insurance, copays as low as $25 for covered patients
- Weight-inclusive care with dietitians and health coaches
- Both virtual (50 states) and in-person clinic options
Watch-outs
- Specific self-pay monthly medication prices not transparently posted
- In-person clinics limited to four metro areas
- Branded-only focus can mean higher cost than compounded routes
Our Verdict
Knownwell edges out 1st Optimal with a higher overall score of 7.7/10 and is particularly strong for Patients wanting branded GLP-1s with obesity-medicine oversight and insurance options. 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 Knownwell if…
You want Patients wanting branded GLP-1s with obesity-medicine oversight and insurance options and a starting price around $349/mo.
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Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →Breeze Meds
Compounded GLP-1 access with named prescribers and 4-pharmacy network
From $169/mo
Get started →Telos Rx
Needle-free and microdosed compounded GLP-1 options with lab-monitored care
From $49/mo
Get started →1st Optimal vs Knownwell: 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.