1st Optimal vs SexyMD
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 →
SexyMD
Best for: shoppers who want installment financing and can commit to a longer plan
Visit SexyMD →1st Optimal and SexyMD 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 $199/mo, and SexyMD edges ahead overall (7.1 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.
SexyMD
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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
SexyMD
Inclusions 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
SexyMD
7.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | SexyMD |
|---|---|---|
| Starting Price | ✓$99/mo | $199/mo |
| Features | ✓8 features | 6 features |
| States Available | Not disclosed | Not disclosed |
| 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 SexyMD
SexyMD is a Nevada telehealth brand better known for sexual-health prescribing that now sells compounded GLP-1 injections alongside it. Both weight-loss products are priced by commitment length rather than by dose: the GLP-1 injection runs $269/month on the 4-week plan down to $199 on a 48-week plan, and the GLP-1/GIP injection $369 down to $299. Financing through Affirm, Klarna and Afterpay is offered at checkout.
Read our full SexyMD 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
SexyMD
What we like
- All four commitment tiers are published on the product page with the per-month rate for each, before any intake.
- The terms name the pharmacy types used — U.S.-licensed 503A pharmacies and 503B outsourcing facilities — rather than leaving fulfillment vague.
- Installment financing is offered through Affirm, Klarna and Afterpay, which is unusual at this price point.
- The legal entity is stated plainly: SexyMD LLC, a Nevada limited liability company, with a published Las Vegas address.
- Terms confirm prescriptions may be filled with either FDA-approved brand medication or compounded product, depending on provider determination.
Watch-outs
- The advertised "from $199 per month" is the 48-week commitment; the month-to-month rate is $269, about 35% higher.
- Product pages never name the molecule — they say "GLP-1" and "GLP-1 + GIP", and only the terms mention semaglutide and tirzepatide.
- The same three customer testimonials run on both product pages, including a GLP-1/GIP testimonial displayed on the semaglutide page.
- "Loved by 800+ women" is repeated across the site with no source or methodology given.
- No individual compounding pharmacy is named, only the 503A/503B categories.
- Support is email-only at hello@sexymd.com — no phone number or published hours.
- State coverage is hedged: available in all 50 states but "some exclusions may apply" depending on pharmacy licensing.
Our Verdict
SexyMD edges out 1st Optimal with a higher overall score of 7.1/10 and is particularly strong for shoppers who want installment financing and can commit to a longer plan. 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 SexyMD if…
You want shoppers who want installment financing and can commit to a longer plan and a starting price around $199/mo.
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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 →Strut Health
Oral-lozenge compounded GLP-1 access
From $99/mo
Get started →1st Optimal vs SexyMD: 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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