1st Optimal vs Rivas Medical Weight Loss
An in-depth comparison of two leading GLP-1 Providers
WeightLossRankings.org is reader-supported. When you buy through links on our site, we may earn an affiliate commission. Learn more
1st Optimal
Best for: GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
Rivas Medical Weight Loss
Best for: MD/VA/FL patients wanting hands-on weekly in-person or telehealth GLP-1 visits
Visit Rivas Medical Weight Loss →1st Optimal and Rivas Medical 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, 1st Optimal starts lower at $99/mo versus $498/mo, and both land at 6.7/10 overall. 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.
Rivas Medical Weight Loss
'Semaglutide $115/week for any dose — All-inclusive price, visit & medication.' That is $498 a calendar month. ⚠ Injections are given ON SITE at weekly visits, not shipped.
billed $165/week for any dose; all-inclusive (visit + medication); ~$715/mo equivalent
Get alerted when GLP-1 prices drop
Join the GLP-1 price-watch list — we re-verify 490+ providers' prices on their own sites and email you when tracked prices move.
What’s included
1st Optimal
What the monthly price covers
Medication
Not disclosed
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
Rivas Medical Weight Loss
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
Rivas Medical Weight Loss
6.7/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Rivas Medical Weight Loss |
|---|---|---|
| Starting Price | ✓$99/mo | $498/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | 3 |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ 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 Rivas Medical Weight Loss
Rivas Medical Weight Loss is a physician-founded program (Paul Rivas MD LLC) combining 15 in-person clinics with telehealth across Maryland, Virginia, and Florida. It offers compounded semaglutide at $115/week and compounded tirzepatide at $165/week, flat for any dose, with each all-inclusive weekly price covering the medication plus a provider visit. The concierge weekly-visit model runs higher than mail-order competitors.
Read our full Rivas Medical 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
Rivas Medical Weight Loss
What we like
- Physician-founded (Paul Rivas MD) with 15 clinics plus telehealth
- Flat price for any dose; weekly provider visits included in every payment
- Offers both compounded semaglutide and tirzepatide
Watch-outs
- Expensive: about $498/mo for semaglutide and $715/mo for tirzepatide (billed weekly)
- Only available in Maryland, Virginia, and Florida
- Weekly-visit concierge model requires more frequent engagement than mail-order
Our Verdict
Both 1st Optimal and Rivas Medical Weight Loss score equally well overall — the right choice depends on your priorities.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Rivas Medical Weight Loss if…
You want MD/VA/FL patients wanting hands-on weekly in-person or telehealth GLP-1 visits and a starting price around $498/mo.
Ready to start? Vetted GLP-1 providers
Vetted telehealth providers that prescribe GLP-1 online.
No insurance needed · vetted by our editors
WeightLossRankings.org is reader-supported. When you buy through links on our site, we may earn an affiliate commission. Learn more
bmiMD
Mainstream telehealth GLP-1 access
From $99/mo
Get started →Synergy Rx
Broadest drug catalog in the Lion MD white-label cluster
From $199/mo
Get started →RxSpan MD
Physician-led, pharmacy-transparent compounded GLP-1 with brand-name options
From $179/mo
Get started →1st Optimal vs Rivas Medical 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
Related comparisons
Continue exploring 1st Optimal and Rivas Medical Weight Loss head-to-heads in the same category.
- 1st Optimal vs Amazon One Medical
- 1st Optimal vs Vytora Health
- 1st Optimal vs Collective
- Rivas Medical Weight Loss vs CoreAge Rx
- Rivas Medical Weight Loss vs EverSlim
- Rivas Medical Weight Loss vs Found
Or see the full category ranking.
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.