1st Optimal vs PreventiveMD
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 →
PreventiveMD
Best for: compounded GLP-1s from $83/mo all-in with brand Wegovy and Zepbound upgrade paths
Visit PreventiveMD →1st Optimal and PreventiveMD 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, PreventiveMD starts at $83/mo, and PreventiveMD edges ahead overall (7.8 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.
PreventiveMD
'As low as $83/mo, all-in' — homepage price, live-verified 2026-07-10
'As low as $97/mo, all-in' — homepage price, live-verified 2026-07-10
Medication starts at $149/mo; a separate $49/mo membership fee applies to brand plans
Medication starts at $149/mo; a separate $49/mo membership fee applies to brand plans
Medication starts at $299/mo; a separate $49/mo membership fee applies to brand plans
What’s included
1st Optimal
Inclusions not disclosed.
PreventiveMD
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Not disclosed
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
PreventiveMD
7.8/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | PreventiveMD |
|---|---|---|
| Starting Price | — | $83/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 36 |
| Compounded | — | ✓ Yes |
| Brand Name | — | ✓ Yes |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 PreventiveMD
PreventiveMD is a physician-guided telehealth platform for GLP-1 weight loss and peptide therapy, offering compounded semaglutide from $83/mo all-in and compounded tirzepatide from $97/mo all-in, plus brand Wegovy, Zepbound, and Foundayo on a membership model. A US-licensed provider reviews each request within 24 hours; approved medication ships to your door with ongoing care through an online portal.
Read our full PreventiveMD 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
PreventiveMD
What we like
- Compounded semaglutide from $83/mo and tirzepatide from $97/mo, billed as one all-in monthly price
- Brand Wegovy, Zepbound, and Foundayo (oral GLP-1) available on the same platform
- US-licensed provider reviews requests within 24 hours — no video visit required
- You aren't charged until a provider approves; checkout places an authorization hold only
- LegitScript-certified; works exclusively with state-licensed US 503A compounding pharmacies
- HSA/FSA-eligible with receipts you can submit to your insurer
- Publishes its state-availability list openly on the site
Watch-outs
- Individual compounding pharmacy partners are not publicly named
- Not available in 14 states + DC, including New York, New Jersey, Virginia, and Wisconsin
- Brand Wegovy, Zepbound, and Foundayo require a $49/mo membership fee on top of medication cost
- 'As low as' pricing — actual monthly cost can be higher depending on your plan
- Orders become non-refundable once provider review or pharmacy fulfillment begins
Our Verdict
PreventiveMD edges out 1st Optimal with a higher overall score of 7.8/10 and is particularly strong for compounded GLP-1s from $83/mo all-in with brand Wegovy and Zepbound upgrade paths. 1st Optimal remains a solid alternative, especially if you're looking for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose PreventiveMD if…
You want compounded GLP-1s from $83/mo all-in with brand Wegovy and Zepbound upgrade paths and a starting price around $83/mo.
Ready to start? Vetted GLP-1 providers
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Embody
Lowest first-month entry pricing on compounded GLP-1s
From $79/mo
Get started →TrimRx
Best overall value
From $179/mo
Get started →Telos Rx
Needle-free and microdosed compounded GLP-1 options with lab-monitored care
From $49/mo
Get started →1st Optimal vs PreventiveMD: 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.