1st Optimal vs Rex MD
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 →
Rex MD
Best for: Men wanting a flat-fee, all-inclusive branded GLP-1 program nationwide
Visit Rex MD →1st Optimal and Rex MD 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 starts lower at $99/mo versus $349/mo, and Rex MD 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
Care membership only — the GLP-1 medication is billed separately and is not priced.
Rex MD
Advertised flat program fee; not on the current weight-management page.
Includes provider care. Rex MD prices this and nothing else on its weight-management page; the Zepbound vial product is in the nav with no published price.
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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
Rex MD
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
Rex MD
7.2/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Rex MD |
|---|---|---|
| Starting Price | ✓$99/mo | $349/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 50 |
| Compounded | — | — |
| Brand Name | ✓ Yes | ✓ Yes |
| 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 Rex MD
Rex MD is a US-based men's-health telehealth platform (a LifeMD brand) offering a 100 percent online GLP-1 weight-management program. It prescribes brand-name semaglutide and Zepbound (tirzepatide) vials, filled through partner pharmacies. The flat monthly program runs about $199 and includes the medical intake, provider consultations, prescribed medication, syringes and free overnight shipping; Zepbound vials start around $349 per month. Providers are US-based, state-licensed clinicians and the platform is LegitScript certified. Rex MD serves all 50 states and does not bill insurance.
Read our full Rex MD 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
Rex MD
What we like
- Flat $199/mo program bundles consult, medication and overnight shipping
- Brand-name semaglutide and Zepbound vials, not just compounded
- Serves all 50 states, fully online
- LegitScript certified with US-based, state-licensed providers
- Backed by parent company LifeMD
Watch-outs
- Does not accept insurance
- Marketed primarily to men via a men's-health platform
- Zepbound vial cost rises with dose titration
- Branded-only program costs more than compounded options
Our Verdict
Rex MD edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for Men wanting a flat-fee, all-inclusive branded GLP-1 program nationwide. 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 and a starting price around $99/mo.
Choose Rex MD if…
You want Men wanting a flat-fee, all-inclusive branded GLP-1 program nationwide and a starting price around $349/mo.
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Sunlight
Compounded GLP-1 with unlimited telehealth visits and free shipping
From $88/mo
Get started →MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →1st Optimal vs Rex MD: 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.