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1st Optimal vs Steady State Health

An in-depth comparison of two leading GLP-1 Providers

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By Eli Marsden · Founding Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

6.7
★★★☆☆3.4/5

Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program

Visit 1st Optimal
VS

Steady State Health

6.9
★★★3.5/5

Best for: Women in Oregon or Washington wanting GLP-1 within perimenopause and menopause care

Visit Steady State Health

1st Optimal and Steady State Health 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, Steady State Health edges ahead overall (6.9 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.

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What’s included

1st Optimal

Inclusions not disclosed.

Steady State Health

What the monthly price covers

Medication

Billed separately

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

Overall

Steady State Health

6.9/10

Value25%

6.5A
vs
B
6.5

Effectiveness25%

7.0A
vs
B
7.5

User Experience15%

6.5A
vs
B
7.0

Trust & Safety15%

6.5A
vs
B
7.0

Accessibility10%

6.5A
vs
B
6.0

Support10%

7.4A
vs
B
7.0

Features & Coverage

Feature1st OptimalSteady State Health
Starting Price
Features8 features6 features
States AvailableNot disclosed2
Compounded
Brand Name
FSA/HSA Accepted
FDA WarningsNoneNone

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 Steady State Health

Steady State Health is a women's-health telehealth practice run by nurse practitioner Josie Cowburn, DNP, FNP-C, serving Oregon and Washington. Its GLP-1 Metabolic Support program prescribes semaglutide or tirzepatide inside a perimenopause and menopause hormone-and-metabolic framework rather than as a standalone weight-loss drug. Clinical support starts at $139/month (or $99/month standalone); the GLP-1 medication is cash-pay and billed separately by the dispensing pharmacy.

Read our full Steady State Health 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

Steady State Health

What we like

  • Prescribes semaglutide or tirzepatide within a perimenopause and menopause hormone-and-metabolic care plan
  • Care delivered by a named women's-health nurse practitioner (Josie Cowburn, DNP, FNP-C)
  • Transparent flat program fee from $139/mo, with a $99/mo standalone GLP-1 support option

Watch-outs

  • Available only to Oregon and Washington residents
  • GLP-1 medication is billed separately by the pharmacy and not included in the program fee
  • Dispensing pharmacy is not publicly named

Our Verdict

Winner: Steady State Health

Steady State Health edges out 1st Optimal with a higher overall score of 6.9/10 and is particularly strong for Women in Oregon or Washington wanting GLP-1 within perimenopause and menopause care. 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 Steady State Health if…

You want Women in Oregon or Washington wanting GLP-1 within perimenopause and menopause care.

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1st Optimal vs Steady State Health: FAQ

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