1st Optimal vs Zealthy
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 →
Zealthy
Best for: not currently recommended — listed for transparency and reader awareness only
Visit Zealthy →1st Optimal and Zealthy 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, Zealthy starts at $286/mo, and Zealthy is the option we'd start with for most patients. 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.
Zealthy
$151 medication + $135 monthly membership
$216 medication + $135 monthly membership
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What’s included
1st Optimal
Inclusions not disclosed.
Zealthy
What the monthly price covers
Medication
Not disclosed
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
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
Zealthy
5.5/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Zealthy |
|---|---|---|
| Starting Price | — | $286/mo |
| Features | ✓8 features | 3 features |
| States Available | Not disclosed | 34 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | ✓None | 2 warnings |
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 Zealthy
Zealthy (legal entity FitRX, LLC, recently renamed to Gronk Inc.) offers compounded semaglutide and tirzepatide via an asynchronous telehealth model. Listed here for completeness with full disclosure of two FDA warning letters and active federal litigation — see warnings and cons sections before considering.
Read our full Zealthy 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
Zealthy
What we like
- Serves 34 states — meaningful nationwide footprint
- Asynchronous model removes friction for patients who don't want a video visit
- Independent licensed prescribers retain full clinical authority
Watch-outs
- Two FDA warning letters for false or misleading marketing of compounded GLP-1s
- Active Novo Nordisk false-advertising lawsuit alleging trademark infringement and marketing compounded drugs as FDA-approved alternatives
- Active DOJ/FTC enforcement alleging undisclosed subscription terms, locked cancellation, and unauthorized health-data sharing
- Founder previously ran Cerebral, which settled with the FTC in 2024 over similar deceptive practices
- Recently rebranded to Gronk Inc. amid active enforcement
- Kept marketing compounded semaglutide after the FDA shortage ended in Feb 2025
- Adds a $135/month membership fee on top of medication — total cash price $286–$351/month
- Compounded only — no FDA-approved Ozempic, Wegovy, Zepbound, or Mounjaro
Our Verdict
Zealthy is our recommended choice here, particularly for not currently recommended — listed for transparency and reader awareness only. 1st Optimal is a solid alternative, especially if you want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program — compare the six-dimension breakdown and pricing below to weigh them for your situation.
Choose 1st Optimal if…
You want Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.
Choose Zealthy if…
You want not currently recommended — listed for transparency and reader awareness only and a starting price around $286/mo.
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Sunlight
Compounded GLP-1 with unlimited telehealth visits and free shipping
From $159/mo
Get started →MadeMed
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 Zealthy: 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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