1st Optimal vs Open Water Rx
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 →
Open Water Rx
Best for: transparency listing only — verify against vetted providers first
Visit Open Water Rx →1st Optimal and Open Water Rx 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, 1st Optimal edges ahead overall (6.7 vs 4.9 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.
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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
Open Water Rx
4.9/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Open Water Rx |
|---|---|---|
| Starting Price | — | — |
| Features | ✓8 features | 0 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | — |
| 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 Open Water Rx
Open Water Rx is a telehealth platform positioned around GLP-1 weight loss and longevity, per its own site. Most details — medications, pricing, states served, pharmacy partner, and clinical leadership — are not surfaced publicly, so this entry exists mainly to confirm the brand and category. Verify specifics directly with the provider before enrolling.
Read our full Open Water Rx 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
Open Water Rx
What we like
- Combines weight-loss and longevity verticals in one brand
- Established brand domain
Watch-outs
- Limited public data — most details are gated behind signup or rendered only in JavaScript
- Pricing not disclosed
- GLP-1 options (semaglutide vs. tirzepatide, compounded vs. brand, injection vs. oral) not stated
- States-served list not disclosed
- Pharmacy partner not named
- LegitScript certification not confirmed
- No FDA compounded-medication disclaimer found
- Named medical director not disclosed
Our Verdict
1st Optimal edges out Open Water Rx 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. Open Water Rx remains a solid alternative, especially if you're looking for transparency listing only — verify against vetted providers first.
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Open Water Rx if…
You want transparency listing only — verify against vetted providers first.
Ready to start? Vetted GLP-1 providers
Vetted telehealth providers that prescribe GLP-1 online.
No insurance needed · vetted by our editors
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Telos Rx
Needle-free and microdosed compounded GLP-1 options with lab-monitored care
From $49/mo
Get started →GobyMeds
Budget-conscious shoppers
From $93/mo
Get started →RNK Health
Compounded GLP-1 alongside NAD+, peptide and longevity add-ons
From $197/mo
Get started →1st Optimal vs Open Water Rx: 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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Or see the full category ranking.
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