Price and states served both move. Read them off the seller's own site before you enroll.How our reviews work →

1st Optimal vs FormidableMD

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

By Ruth Calder · Enforcement Editor
Editorially reviewed & fact-checked against primary sources · How we verify contentLast reviewed
1st Optimal logo

1st Optimal

3.9
★★☆☆☆2/5

Best for: coaching bundled into the price rather than sold separately

Visit 1st Optimal
VS
FormidableMD logo

FormidableMD

7.0
★★★3.5/5

Best for: compounded semaglutide at $169/month

Visit FormidableMD

Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, FormidableMD starts at $169/mo, and FormidableMD finishes ahead, 7.0 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.

FormidableMD

1mgCompounded
$169/mo
semaglutide

Dose-tiered: 1mg $169, 2mg $189, 5mg $209, 10mg $269/mo. Compounded or FDA-approved options. Separate $199 initial consult + $99 follow-up visits

10mgCompounded
$199/mo
tirzepatide

Dose-tiered: 10mg $199, 20mg $239, 30mg $279, 40mg $319/mo. Compounded or FDA-approved. Plus $199 initial consult + $99 follow-ups

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

FormidableMD

Covered by the monthly price

Medication

In the price

Clinician visits

Charged on top

Shipping

Not stated

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

Overall

FormidableMD

7.0/10

Value25%

3.0A
vs
B
7.1

Effectiveness25%

5.0A
vs
B
10.0

User Experience15%

2.0A
vs
B
7.5

Trust & Safety15%

4.0A
vs
B
7.5

Accessibility10%

5.0A
vs
B
2.2

Support10%

5.0A
vs
B
3.0

Features & Coverage

Feature1st OptimalFormidableMD
Starting Price$169/mo
Features8 features6 features
States AvailableNot disclosed1
Compounded✓ Yes
Brand Name
FSA/HSA Accepted✓ Yes
FDA WarningsNoneNone

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 FormidableMD

Pay as you go: $199 for the first consultation, $99 for each follow-up, and no membership or commitment behind either. Dose sets the drug cost, semaglutide opening at $169/mo and tirzepatide at $199/mo. Based in Florida and led by physicians on a cash-pay basis, the practice also runs nutrition coaching, labs, urgent care, HRT/TRT and peptides, and sells tirzepatide and semaglutide as orals and in compounded and FDA-approved forms alike. Compounded drugs come out of 503A pharmacies. Visits qualify for FSA/HSA.

Read our full FormidableMD 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

FormidableMD

What we like

  • Semaglutide at $169 a month, within the normal band around this register's $189 median for the same drug and form
  • 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
  • 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

Watch-outs

  • Billed separately from the monthly figure: consult
  • Coverage is published for 1 states only, so this may not reach you
  • 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

Winner: FormidableMD

FormidableMD takes it, 7.0 against 3.9, and it is especially strong on compounded semaglutide at $169/month. 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 FormidableMD if…

You want compounded semaglutide at $169/month and an opening price near $169 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

8.5

Strut Health

Semaglutide at $99/month, 48% under the register median

7.9

Oak

Semaglutide at $119/month, 37% under the register median

8.8

Found

Tirzepatide at $169/month, 37% under the register median

1st Optimal vs FormidableMD: FAQ

Glossary

The words sellers use, defined. Tap any term.

Continue exploring 1st Optimal and FormidableMD head-to-heads in the same category.

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.