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1st Optimal vs Lean Meds

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: GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS
Lean Meds logo

Lean Meds

7.6
★★★3.8/5

Best for: a flat monthly GLP-1 price that never rises with your dose, from a service that names its pharmacies

Visit Lean Meds

1st Optimal and Lean Meds 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, Lean Meds starts at $79/mo, and Lean Meds edges ahead overall (7.6 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.

Lean Meds

Any dose, month-to-month (same price at every dose)Compounded
$79/mo
semaglutide

Standing month-to-month rate. The advertised $69 is the 12-month prepay tier; 3-month is $76 and 6-month is $73.

Any dose, month-to-month (same price at every dose)Compounded
$109/mo
tirzepatide

Standing month-to-month rate. Prepay tiers: $105 for 3 months, $100 for 6, $95 for 12.

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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

Lean Meds

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

Lean Meds

7.6/10

Value25%

6.5A
vs
B
8.0

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.5

Trust & Safety15%

6.5A
vs
B
7.0

Accessibility10%

6.5A
vs
B
8.5

Support10%

7.4A
vs
B
7.0

Features & Coverage

Feature1st OptimalLean Meds
Starting Price$79/mo
Features8 features7 features
States AvailableNot disclosed50
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 Lean Meds

Lean Meds is a compounded GLP-1 telehealth service operated by Trinity HealthCare Supply, LLC, using the OpenLoop Health clinician network. It charges one flat monthly rate that does not rise as your dose increases, and it names both its prescribing physicians and its five dispensing pharmacies. Month-to-month pricing starts at $79 for compounded semaglutide and $109 for compounded tirzepatide, with free shipping and the telehealth visit included.

Read our full Lean Meds 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

Lean Meds

What we like

  • One flat monthly price that does not increase as your dose is titrated up
  • Names five dispensing pharmacies outright: Belmar, Strive, Epiq Scripts, Casa Pharma Rx and The Pharmacy Hub
  • Names its prescribing physicians with verifiable NPI numbers, which few competitors do
  • Full price list is published before any intake, and the monthly rate includes the visit and shipping
  • Month-to-month with no contract, and available in all 50 states

Watch-outs

  • The advertised $69 and $95 rates are 12-month prepay tiers; month-to-month is $79 and $109
  • A countdown timer claims the price rises within hours, which is a pressure tactic rather than a real deadline
  • The LegitScript link goes to the generic lookup form with no seal ID, so certification could not be verified
  • Consultation fees are non-refundable and all other sales are final except where the refund policy applies
  • Cancellation must reach support by email at least 48 hours before the monthly processing date

Our Verdict

Winner: Lean Meds

Lean Meds edges out 1st Optimal with a higher overall score of 7.6/10 and is particularly strong for a flat monthly GLP-1 price that never rises with your dose, from a service that names its pharmacies. 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.

Choose Lean Meds if…

You want a flat monthly GLP-1 price that never rises with your dose, from a service that names its pharmacies and a starting price around $79/mo.

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1st Optimal vs Lean Meds: FAQ

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