1st Optimal vs Silhouette MD
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 →
Silhouette MD
Best for: people who want hands-on concierge support alongside compounded GLP-1 treatment
Visit Silhouette MD →1st Optimal and Silhouette 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, Silhouette MD starts at $149/mo, and Silhouette 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
Pricing not publicly listed.
Silhouette MD
Lowest advertised tier ('as low as').
Lowest advertised tier ('as low as').
Oral formulation; lowest advertised tier.
Oral formulation; lowest advertised tier.
What’s included
1st Optimal
Inclusions not disclosed.
Silhouette MD
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Not disclosed
Lab work
Not disclosed
Coaching
Billed separately
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
Silhouette MD
7.2/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Silhouette MD |
|---|---|---|
| Starting Price | — | $149/mo |
| Features | ✓8 features | 5 features |
| States Available | Not disclosed | Not disclosed |
| 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 Silhouette MD
Concierge-style GLP-1 telehealth offering compounded semaglutide and tirzepatide in both injectable and oral forms, with provider oversight and full-service support included on every plan. Prescriptions are issued and fulfilled by licensed clinical partner OpenLoop Health.
Read our full Silhouette 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
Silhouette MD
What we like
- Compounded semaglutide and tirzepatide in both injectable and oral formulations
- Concierge-level support — monitoring, expert guidance, and check-ins included on every plan
- Transparent, published pricing starting at $149/mo for semaglutide injection
- Prescriptions issued and fulfilled by licensed clinical partner OpenLoop Health
Watch-outs
- Tirzepatide ($299/mo) and oral options ($263–$325/mo) priced above many compounded competitors
- State availability not published
- Newer brand with limited independent review history
- Medications are compounded, not FDA-approved brand-name
Our Verdict
Silhouette MD edges out 1st Optimal with a higher overall score of 7.2/10 and is particularly strong for people who want hands-on concierge support alongside compounded GLP-1 treatment. 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 Silhouette MD if…
You want people who want hands-on concierge support alongside compounded GLP-1 treatment and a starting price around $149/mo.
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Bodybuilding Health+
Fitness-brand compounded GLP-1 with hormone and performance programs
From $179/mo
Get started →Gala
Compounded GLP-1/GIP combo therapy on a yearly subscription with free shipping nationwide
From $149/mo
Get started →Trimi Health
Budget-conscious shoppers
From $99/mo
Get started →1st Optimal vs Silhouette 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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