1st Optimal vs ElixaMD
An in-depth comparison of two leading GLP-1 Providers
Some of the links on this page earn us money. If you sign up with a provider after following one, that provider may pay GLP Watchdog a commission. Learn more
1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
ElixaMD
Best for: seeing what it charges before you answer any medical questions
Visit ElixaMD →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, ElixaMD starts at $179/mo, and ElixaMD finishes ahead, 6.3 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.
ElixaMD
'$179 first month' intro/sale, no contract; ongoing/higher-dose tiers ~$249-$299; HSA/FSA eligible
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
ElixaMD
Covered by the monthly price
Medication
In the price
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
Not stated
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
ElixaMD
6.3/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | ElixaMD |
|---|---|---|
| Starting Price | — | $179/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | Not disclosed |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| 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 ElixaMD
The $179 first-month figure for compounded semaglutide injections is an intro rate. No membership, no contract and no insurance are involved, and delivery costs nothing. Everything else folds in: a patient portal, 24/7 support, care coaching, dietician visits at no charge and 1:1 physician guidance. HSA/FSA money qualifies. ElixaMD does something rare and names its compounders, RedRock and Beaker, alongside a full legal suite, and it discloses that compounded drugs are not FDA-approved. Semaglutide is the only molecule advertised, and no verifiable LegitScript seal is displayed.
Read our full ElixaMD 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
ElixaMD
What we like
- Publishes a price on its own site before the medical questionnaire, so it can be compared without handing over health information
- The monthly figure covers medication, consult, shipping
- No FDA warning letter matched this operator when we searched our enforcement register
Watch-outs
- 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 is compounded rather than FDA-approved, so it has not been reviewed by the agency for safety, effectiveness or manufacturing quality
Our Verdict
ElixaMD takes it, 6.3 against 3.9, and it is especially strong on seeing what it charges before you answer any medical questions. 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 ElixaMD if…
You want seeing what it charges before you answer any medical questions and an opening price near $179 a month.
Ready to start? Vetted GLP-1 providers
Vetted telehealth providers that prescribe GLP-1 online.
No insurance needed · vetted by our editors
Some of the links on this page earn us money. If you sign up with a provider after following one, that provider may pay GLP Watchdog a commission. Learn more
Oak
Semaglutide at $119/month, 37% under the register median
From $119/mo
Get started →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 →1st Optimal vs ElixaMD: 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
Related comparisons
Continue exploring 1st Optimal and ElixaMD head-to-heads in the same category.
- 1st Optimal vs Trimi Health
- 1st Optimal vs Embody
- 1st Optimal vs He & She MD
- ElixaMD vs Lean Meds
- ElixaMD vs NextMeds
- ElixaMD vs bmiMD
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.