1st Optimal vs Aspire Health
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Aspire Health
Best for: bloodwork inside the $205/month rather than billed on top
Visit Aspire Health →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Aspire Health starts at $205/mo, and Aspire Health finishes ahead, 6.1 to 3.9. What follows: the prices, what each plan actually covers, the six-dimension score, where each one is weak, and who should pick which.
Pricing
1st Optimal
Pricing not publicly listed.
Aspire Health
Verbatim from weight-loss page: '$149' for 5-week supply of compounded semaglutide/B6 (low dose 0.25–0.5 mg) + $75/month LoseIt program fee = ~$205/month total. 'Medication costs are not included in either program fee.' 15-week supply listed at $399 (~$115/mo for medication alone). program fee enrollment fee $200 ($175 online).
Verbatim from weight-loss page: '$199' for 5-week supply of compounded semaglutide/B6 (high dose 1.7+ mg) + $75/month LoseIt program fee = ~$247/month total. 15-week supply listed at $499 (~$144/mo for medication alone). 'Medication costs are not included in either program fee.'
Verbatim from weight-loss page: '$199' for 4-week supply of Wegovy (brand semaglutide, starter doses) + $75/month LoseIt program fee = ~$274/month total. Other Wegovy doses listed at $399/4 weeks (~$474/mo total with program fee). 'Medication costs are not included in either program fee.'
Verbatim from weight-loss page: '$249' for 5-week supply of compounded tirzepatide/B6 (2.5 mg) + $75/month LoseIt program fee = ~$289/month total. 15-week supply at $699 (~$202/mo for medication alone). 'Medication costs are not included in either program fee.'
Verbatim from weight-loss page: '$349' for 5-week supply of compounded tirzepatide/B6 (5–15 mg) + $75/month LoseIt program fee = ~$375/month total. 15-week supply at $999 (~$289/mo for medication alone). 'Medication costs are not included in either program fee.'
Verbatim from weight-loss page: '$299' for 4-week supply of Zepbound (brand tirzepatide, 2.5 mg) + $75/month LoseIt program fee = ~$374/month total. Higher doses (7.5–15 mg) listed at $449/4wks (~$524/mo total with program fee). 'Medication costs are not included in either program fee.'
What’s included
1st Optimal
Covered by the monthly price
Medication
Not stated
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
In the price
Aspire Health
Covered by the monthly price
Medication
In the price
Clinician visits
In the price
Shipping
In the price
Lab work
In the price
Coaching
In the price
Score breakdown
Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.
1st Optimal
3.9/10
Aspire Health
6.1/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Aspire Health |
|---|---|---|
| Starting Price | — | $205/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | ✓ Yes |
| FSA/HSA Accepted | — | ✓ Yes |
| FDA Warnings | None | None |
About 1st Optimal
Neither a monthly price nor a list of states is published. 1st Optimal operates out of Michigan across telehealth and functional medicine, writing the GLP-1s semaglutide and tirzepatide either as a weekly injection or as a daily oral tablet. Around the prescription it stacks at-home lab testing, interpretation of the blood work, coaching without limit and protocols built individually, all framed as long-term weight loss and longevity. Credentialed providers work virtually, treatment goes to the home, and nothing binds you to a long contract.
Read our full 1st Optimal review →About Aspire Health
Medication is billed on top of the membership, with compounded semaglutide beginning at $149 for a 5-week supply. The LoseIt membership itself costs $200 to enroll plus $75/month, buying ongoing support, Slimpossible app access, provider visits every 2-3 months and lab orders with interpretation. Aspire Health is a telehealth practice based in Nebraska. A named PA/NP clinical team writes the prescriptions, for compounded semaglutide and tirzepatide formulated with B6 as well as brand-name Wegovy and Zepbound.
Read our full Aspire Health review →Pros & Cons
1st Optimal
What we like
- The monthly figure covers consult, shipping, coaching
- No FDA warning letter matched this operator when we searched our enforcement register
- A live video visit with a clinician is required before a prescription, which is slower than a form and is the more careful intake
- Baseline bloodwork is required before a prescription
Watch-outs
- No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
- No state list is on record here, so whether it serves your state cannot be confirmed from this page
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
Aspire Health
What we like
- Semaglutide at $205 a month, within the normal band around this register's $189 median for the same drug and form
- The monthly figure covers medication, consult, shipping, labs, coaching
- No FDA warning letter matched this operator when we searched our enforcement register
Watch-outs
- No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
- No state list is on record here, so whether it serves your state cannot be confirmed from this page
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
- Its semaglutide and tirzepatide are compounded rather than FDA-approved, so they have not been reviewed by the agency for safety, effectiveness or manufacturing quality
Our Verdict
Aspire Health takes it, 6.1 against 3.9, and it is especially strong on bloodwork inside the $205/month rather than billed on top. 1st Optimal is no weak second and may fit you better on coaching bundled into the price rather than sold separately.
Choose 1st Optimal if…
You want coaching bundled into the price rather than sold separately.
Choose Aspire Health if…
You want bloodwork inside the $205/month rather than billed on top and an opening price near $205 a month.
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Found
Tirzepatide at $169/month, 37% under the register median
From $99/mo
Get started →Telos Rx
Starting below a standard dose, with microdose tiers
From $49/mo
Get started →MyDrHank
An oral route if you will not self-inject
From $25/mo
Get started →1st Optimal vs Aspire Health: FAQ
Glossary
The words sellers use, defined. Tap any term.
- 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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Or see the full category ranking.
Novo Nordisk A/S owns the Wegovy®, Ozempic® and Rybelsus® marks; Eli Lilly and Company owns Mounjaro® and Zepbound®. Every other product name and mark on this page belongs to whoever owns it. No pharmaceutical manufacturer is affiliated with GLP Watchdog. See trademark disclaimer.