1st Optimal vs Livea
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 →
Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Livea starts at $99/mo, and Livea finishes ahead, 7.2 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.
Livea
Verbatim from /glp-1/ FAQ: 'compounded semaglutide starting at $99/month.' Once-weekly injectable. Medical page discloses separate $69/mo program fee covering consultation and supervision — whether $99/mo is inclusive of or additive to the program fee is clarified at free consultation.
Verbatim from /glp-1/ FAQ: 'Compounded tirzepatide starts at $199/month when available.' Availability subject to FDA compounding status — as of mid-2026 Livea states the FDA shortage end affects compounded tirz; Livea monitors and offers eligibility-based options including branded alternatives.
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
Livea
Covered by the monthly price
Medication
In the price
Clinician visits
In the price
Shipping
In the price
Lab work
Charged on top
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
Livea
7.2/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Livea |
|---|---|---|
| Starting Price | — | $99/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 4 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| 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 Livea
Compounded semaglutide is priced from $99/mo, compounded tirzepatide from $199/mo when available. Bundled into the program: regular provider check-ins, health coaching, registered dietitian nutrition and InBody scans. Livea, a medical weight loss clinic with physician supervision, was founded in 2011, is LegitScript certified, and runs 8 clinics across MN and WI with telehealth in Florida, Iowa, MN and WI. Livea Medical, PLLC, a physician-owned practice, provides medical services. It claims 50,000+ clients and five straight Minnesota's Best Weight Loss Program wins.
Read our full Livea 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
Livea
What we like
- Semaglutide at $99 a month, 48% below the $189 median for the same drug and form across this register
- The monthly figure covers medication, consult, shipping, 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
- Billed separately from the monthly figure: labs
- Coverage is published for 4 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
Livea takes it, 7.2 against 3.9, and it is especially strong on semaglutide at $99/month, 48% under the register median. 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 Livea if…
You want semaglutide at $99/month, 48% under the register median and an opening price near $99 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
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 →SkinnyRx
Starting below a standard dose, with microdose tiers
From $149.25/mo
Get started →1st Optimal vs Livea: 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 Livea head-to-heads in the same category.
- 1st Optimal vs Trimi Health
- 1st Optimal vs Embody
- 1st Optimal vs He & She MD
- Livea vs Lean Meds
- Livea vs NextMeds
- Livea 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.