1st Optimal vs Onyx Weight Loss
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 →
Onyx Weight Loss
Best for: NP-led GLP-1 telehealth across 8 states; sema from $228/mo or tirz from $280/mo, med+ship incl.
Visit Onyx Weight Loss →1st Optimal and Onyx Weight Loss 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, Onyx Weight Loss starts at $99/mo, and 1st Optimal edges ahead overall (6.7 vs 6.1 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.
Onyx Weight Loss
Verbatim: 'Starting at $228/month' (GLP-1 Agonist plan). Includes medication and supplies shipped to home. Entry tier only; higher-dose pricing not disclosed.
Verbatim: 'Starting at $280/month' (GLP-1/GIP Agonist plan). Includes medication and supplies. Entry tier only; specific drug name inferred from GLP-1/GIP dual agonist designation.
Verbatim: '$99/MONTH' (GLP-1 Microdosing plan). Low-dose gradual-start option.
What’s included
1st Optimal
Inclusions not disclosed.
Onyx Weight Loss
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
Onyx Weight Loss
6.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Onyx Weight Loss |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 8 |
| 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 Onyx Weight Loss
Onyx Weight Loss is a nurse-practitioner-led telehealth clinic based in Mooresville, NC, offering GLP-1 and GLP-1/GIP weight-loss medications alongside peptides and HRT across 8 states. Founded by Tasha Vangile FNP-C and Madalyn Vangile RN, plans start at $228/month for GLP-1 (semaglutide-type) and $280/month for GLP-1/GIP (tirzepatide-type), with medication and supplies shipped home via Strive Pharmacy partner. A $99/month GLP-1 microdosing option is also available for a gradual-titration start.
Read our full Onyx Weight Loss 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
Onyx Weight Loss
What we like
- Competitive entry pricing: semaglutide from $228/mo and tirzepatide from $280/mo with medication + supplies included
- Nurse-practitioner-led care: founder Tasha Vangile FNP-C (20+ years) and Stephanie Robison APRN-CNP (27 years experience)
- Low-cost $99/mo GLP-1 microdosing option for patients who prefer a gradual titration start
- Strive Pharmacy partnership implies compounded 503A-quality supply chain from a known pharmacy
- Multi-modal clinic: GLP-1 + peptides + HRT + nutrition coaching available under one provider team
Watch-outs
- Only 8 states (NC, CO, ME, VT, VA, IA, NH, PA) — excludes the majority of the US
- No LegitScript certification; credentialing evidence limited to local 2025 Best of Iredell award
- Specific drug names (semaglutide/tirzepatide) never stated on website; compounded status inferred, not disclosed
- Labs not included or mentioned; no baseline bloodwork protocol published
- Pricing shown as 'Starting at' with no dose-escalation tier pricing disclosed publicly
Our Verdict
1st Optimal edges out Onyx Weight Loss with a higher overall score of 6.7/10 and is particularly strong for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. Onyx Weight Loss remains a solid alternative, especially if you're looking for NP-led GLP-1 telehealth across 8 states; sema from $228/mo or tirz from $280/mo, med+ship incl..
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Onyx Weight Loss if…
You want NP-led GLP-1 telehealth across 8 states; sema from $228/mo or tirz from $280/mo, med+ship incl. and a starting price around $99/mo.
Ready to start? Vetted GLP-1 providers
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No insurance needed · vetted by our editors
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Gala
Compounded GLP-1/GIP combo therapy on a yearly subscription with free shipping nationwide
From $149/mo
Get started →Trimi Health
Budget-conscious shoppers
From $99/mo
Get started →Enhance MD
Lab-monitored compounded GLP-1 with mandatory video visit
From $49/mo
Get started →1st Optimal vs Onyx Weight Loss: 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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