1st Optimal vs Zealthy
An in-depth comparison of two leading GLP-1 Providers
WeightLossRankings.org is reader-supported. When you buy through links on our site, we may earn an affiliate commission. Learn more
1st Optimal
Best for Patients wanting GLP-1 therapy within a lab-driven functional-medicine programZealthy
Best for not currently recommended — listed for transparency and reader awareness onlyStarting at $286/mo
Side-by-Side Comparison
| Feature | 1st Optimal | Zealthy |
|---|---|---|
| Overall Score | ✓6.7/10 | 4.8/10 |
| Starting Price | — | $286/mo |
| Editorial Rating | ✓3.4 ★ /5 | 2.4 ★ /5 |
| Features | ✓8 features | 3 features |
| States Available | 0 | ✓34 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | ✓None | 2 warnings |
Pros & Cons
1st Optimal
Pros
- ✓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
Cons
- ✗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
Pros
- ✓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
Cons
- ✗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
1st Optimal edges out Zealthy with a higher overall score of 6.7/10 and is particularly strong for Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. Zealthy remains a solid alternative, especially if you're looking for not currently recommended — listed for transparency and reader awareness only.
Glossary references
Key terms in this article, linked to their canonical definitions.
- 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
Related comparisons
Continue exploring 1st Optimal and Zealthy head-to-heads in the same category.
- 1st Optimal vs CoreAge Rx
- 1st Optimal vs TrimRx
- 1st Optimal vs Amazon One Medical
- Zealthy vs NovoCare Pharmacy
- Zealthy vs Vytora Health
- Zealthy vs Enhance MD
Or see the full category ranking.
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.