1st Optimal vs Rivas Medical 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 →
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, Rivas Medical Weight Loss starts at $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
Pricing not publicly listed.
Rivas Medical Weight Loss
billed $115/week for any dose; all-inclusive (visit + medication); ~$498/mo equivalent
billed $165/week for any dose; all-inclusive (visit + medication); ~$715/mo equivalent
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What’s included
1st Optimal
Inclusions not disclosed.
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 | — | $498/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | 3 |
| 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 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 Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
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.
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SkinnyRx
Mainstream telehealth GLP-1 access
From $149.25/mo
Get started →Embody
Low flat-rate compounded GLP-1 pricing at every dose
From $79/mo
Get started →YourEra
$99 first-month entry pricing on compounded GLP-1s
From $99/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
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