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1st Optimal vs Oak

An in-depth comparison of two leading GLP-1 Providers

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6.7

1st Optimal

Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program
★★★☆☆3.4
Semaglutide GLP-1Tirzepatide GLP-1Oral tablet optionAt-home lab testing
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7.6

Oak

Best for compounded semaglutide and tirzepatide at a flat monthly price
★★★3.8

Starting at $80/mo

CompoundedSemaglutideTirzepatideLegitScript Verified
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Side-by-Side Comparison

Feature1st OptimalOak
Overall Score6.7/107.6/10
Starting Price$80/mo
Editorial Rating3.4 ★ /53.8 ★ /5
Features8 features4 features
States Available00
Compounded✓ Yes
Brand Name
FSA/HSA Accepted
FDA WarningsNoneNone

Pros & Cons

1st Optimal

Pros

  • 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

Cons

  • 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

Oak

Pros

  • Both compounded semaglutide ($130/mo) and tirzepatide ($199/mo) on a single platform
  • $50 off first month with code OAKNEW50
  • LegitScript-certified pharmacy network
  • No video call required for initial approval; flat per-month pricing across all dose strengths

Cons

  • Pharmacy partners are not publicly named on the marketing site (material gap for YMYL disclosure)
  • Operates in 45 states per Terms of Use, but the public state list is gated behind the signup intake
  • No brand-name Wegovy / Zepbound / Mounjaro / Ozempic available — compounded only
  • Fees are non-refundable per Terms of Use; binding arbitration under Delaware law

Our Verdict

Winner: OakScore: 7.6/10

Oak edges out 1st Optimal with a higher overall score of 7.6/10 and is particularly strong for compounded semaglutide and tirzepatide at a flat monthly price. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Glossary references

Key terms in this article, linked to their canonical definitions.

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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.