1st Optimal vs Shapely
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 →
Shapely
Best for: Insurance-accepted telehealth with compounded sema $99/mo and tirz $166/mo; CA, FL, NY, TX (expanding)
Visit Shapely →1st Optimal and Shapely 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, Shapely starts at $99/mo, and Shapely edges ahead overall (7.3 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.
Shapely
Verbatim from semaglutide medication page: 'Starting at $99/month'. Starter 3-month supply at lowest titration dose ($297/quarter). Tiered: ~$139/mo (low-mid dose), ~$179/mo (high dose). Free 2-day shipping; syringes and alcohol pads included. Via state-licensed 503A/503B compounding pharmacy. A separate telehealth recurring plan ($99/mo, $49 first-month promo) is required in addition to the medication cost.
Verbatim from tirzepatide medication page: 'Starting at $166/month'. Starter dose at lowest titration. Tiered: ~$249/mo (low-mid dose), ~$299/mo (high dose). Free 2-day shipping; syringes and alcohol pads included. Via state-licensed 503A/503B compounding pharmacy. Self-pay only for compounded tirz. A separate telehealth recurring plan ($99/mo, $49 first-month promo) is required in addition to the medication cost.
What’s included
1st Optimal
Inclusions not disclosed.
Shapely
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
Lab work
Billed separately
Coaching
Included
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
Shapely
7.3/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Shapely |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 4 |
| 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 Shapely
Shapely is a GLP-1 telehealth platform founded by Dr. Justin Zaghi, MD/MBA, a Harvard-trained physician board-certified in both internal medicine and obesity medicine. The service accepts major PPO insurance and Medicare for brand-name GLP-1s including Wegovy, Ozempic, Zepbound, and Mounjaro, while offering compounded semaglutide from $99/month and compounded tirzepatide from $166/month for self-pay patients — both with free 2-day shipping and supplies included via state-licensed 503A/503B pharmacies.
Read our full Shapely 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
Shapely
What we like
- Founded by Dr. Justin Zaghi, MD/MBA — Harvard-trained, board-certified in internal medicine and obesity medicine, with Medical Director Ana Lisa
- Brand-name GLP-1s (Wegovy, Ozempic, Zepbound, Mounjaro, Foundayo) covered by major PPO and Medicare at copay
- Compounded semaglutide from $99/month with free 2-day shipping, syringes, and supplies included via 503A/503B pharmacy
- 1:1 registered dietitian (RDN) and monthly video provider visits included in every plan; unlimited chat and app support
- Cellular smart scale provided to qualifying patients for ongoing weight tracking throughout the program
Watch-outs
- Currently available only in California, Florida, New York, and Texas — 46 states unserved despite announced expansion
- Telehealth subscription ($99/mo self-pay, $49 first-month promo) is charged separately from compounded medication cost
- Labs not included — $75 flat rate for uninsured patients; baseline bloodwork may be required before prescribing
- No LegitScript certification found on any public page
- Compounding pharmacy partner not named publicly; 503A/503B status claimed but specific pharmacy undisclosed
Our Verdict
Shapely edges out 1st Optimal with a higher overall score of 7.3/10 and is particularly strong for Insurance-accepted telehealth with compounded sema $99/mo and tirz $166/mo; CA, FL, NY, TX (expanding). 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 Shapely if…
You want Insurance-accepted telehealth with compounded sema $99/mo and tirz $166/mo; CA, FL, NY, TX (expanding) and a starting price around $99/mo.
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Live Vital
Shoppers who want low-cost, physician-led compounded GLP-1 with peptide and hormone options
From $99/mo
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Fitness-brand compounded GLP-1 with hormone and performance programs
From $179/mo
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Compounded GLP-1/GIP combo therapy on a yearly subscription with free shipping nationwide
From $149/mo
Get started →1st Optimal vs Shapely: 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.