1st Optimal vs Trellis Vitality
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 →
Trellis Vitality
Best for: body-composition tracking and flat per-dose pricing without a membership fee
Visit Trellis Vitality →1st Optimal and Trellis Vitality 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, Trellis Vitality starts at $150/mo, and Trellis Vitality edges ahead overall (7.5 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.
Trellis Vitality
Per-month rate falls on longer plans: $150 monthly, $140 on 3 months, $133 on 6 months. All dosages cost the same.
Per-month rate falls on longer plans: $199 monthly, $189 on 3 months, $179 on 6 months. All dosages cost the same.
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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
Trellis Vitality
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Included
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
Trellis Vitality
7.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Trellis Vitality |
|---|---|---|
| Starting Price | — | $150/mo |
| Features | ✓8 features | 7 features |
| States Available | Not disclosed | 50 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 Trellis Vitality
Trellis Vitality is an online longevity clinic that frames weight loss around body composition rather than scale weight. Compounded semaglutide starts at $150 a month and tirzepatide at $199, with every dose priced the same and no membership or consult fee layered on top. The program pairs GLP-1s with at-home biomarker panels, a 90-day re-test, and muscle-preserving options such as tesamorelin and glycine formulations. Trellis is a care-coordination company; prescribing is done by the Arora Health provider network and dispensing by Houston pharmacy VialsRX.
Read our full Trellis Vitality 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
Trellis Vitality
What we like
- Names both its pharmacy (VialsRX, Houston TX) and its prescribing network, with a street address and phone number for the pharmacy.
- All dosages cost the same, and there is no membership fee or consult charge on top of the monthly price.
- Frames the program around body composition, with at-home biomarker panels and a 90-day re-test rather than scale weight alone.
- Will review labs from an existing compounded program and recommend protocol adjustments free of charge.
Watch-outs
- Headline stats (92% biomarker improvement, $4,000 average annual saving, 3.4 weeks saved) are unsourced and cannot be checked.
- The "4.7 / 5 · 5,000+ current patients" rating names no review platform, so it cannot be verified against a public record.
- Prescribing runs through the Arora Health network, which several unrelated telehealth brands also use, so the clinical layer is not exclusive.
- Refund eligibility is decided per order rather than by a stated policy, so outcomes are discretionary.
Our Verdict
Trellis Vitality edges out 1st Optimal with a higher overall score of 7.5/10 and is particularly strong for body-composition tracking and flat per-dose pricing without a membership fee. 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.
Choose Trellis Vitality if…
You want body-composition tracking and flat per-dose pricing without a membership fee and a starting price around $150/mo.
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Sunlight
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Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →1st Optimal vs Trellis Vitality: 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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