1st Optimal vs MedLeanRx
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 →
MedLeanRx
Best for: Texas-only compounded semaglutide at $149/mo, plus brand options
Visit MedLeanRx →1st Optimal and MedLeanRx 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, MedLeanRx starts at $149/mo, and MedLeanRx edges ahead overall (7.2 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
Pricing not publicly listed.
MedLeanRx
Weekly semaglutide vial $149/mo; plans 'start at $149/month for the starting dose' — pricing may vary with medication and dosage
Needle-free daily oral semaglutide tablets, $149/mo
$269/mo standard; intro bundle: 2-month supply at 2 mg weekly for $325 (~$163/mo), Texas clients only, while supplies last
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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
MedLeanRx
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
MedLeanRx
7.2/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | MedLeanRx |
|---|---|---|
| Starting Price | — | $149/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 1 |
| 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 MedLeanRx
MedLeanRx is a physician-guided telehealth weight-loss clinic serving Texas only, based in Spring, TX. It prescribes compounded semaglutide as a weekly injection or daily oral tablet at $149/month and compounded tirzepatide at $269/month, plus a brand pathway for Wegovy, Zepbound, and Foundayo (orforglipron) at a $99/month fee where medication is billed separately. A 5-minute online assessment gets a 24-48 hour physician review, with free shipping and cancel-anytime plans.
Read our full MedLeanRx 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
MedLeanRx
What we like
- Compounded semaglutide $149/mo in both weekly injection and daily oral tablet form
- Brand pathway for Wegovy, Zepbound, and Foundayo (orforglipron) at a $99/mo fee plus medication cost
- Intro bundle: 2 months of compounded tirzepatide (2 mg weekly) for $325 — about $163/mo
- LegitScript seal displayed; named supervising physician (Dr. Johnson Uzor, MD)
- Free shipping, no hidden fees, and cancel-anytime plans per homepage trust chips
- 5-minute online assessment with 24-48 hour physician review — 100% online, no clinic visits
Watch-outs
- Texas only — not available in the other 49 states
- Compounded tirzepatide is $269/mo at standard pricing, above the ~$249 market median
- Strict no-refund policy: 'All sales are final' per Terms & Conditions
- Pharmacy partner not publicly named — a transparency gap for a compounding service
- Legal entity name and founding details not published on the site
- Brand-medication total cost not published — $99/mo fee plus the separate cost of medication
Our Verdict
MedLeanRx edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for Texas-only compounded semaglutide at $149/mo, plus brand options. 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 MedLeanRx if…
You want Texas-only compounded semaglutide at $149/mo, plus brand options and a starting price around $149/mo.
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Physician-led, pharmacy-transparent compounded GLP-1 with brand-name options
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Oral-lozenge compounded GLP-1 access
From $99/mo
Get started →YourEra
$99 first-month entry pricing on compounded GLP-1s
From $99/mo
Get started →1st Optimal vs MedLeanRx: 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.